Sample records for public health preparedness

Policymakers are increasingly seeking to determine whether the federal government's recent investments in publichealthpreparedness have left the publichealth system better prepared to respond to large-scale publichealth emergencies. Yet, there remain questions about how to define "publichealth emergency preparedness," how much preparedness is enough, and how preparedness can be measured and assessed. This chapter identifies the key challenges associated with measuring publichealthpreparedness and reviews approaches currently in use. We also identify some emerging measurement techniques that might help address some of these challenges. PMID:17129174

Publichealth and emergency preparedness have become central concepts in the current restructuring of various regional‐, national‐ and global‐level publichealth and emergency management agencies and systems. In this article, a glossary of the most important terms and concepts currently pertaining to publichealthpreparedness is provided with a focus on systems‐level and organisational issues. PMID:17372286

September 11 2001 attacks and following Anthrax mailings introduced emergent need for developing technologies that can distinguish between man made and natural incidents in the publichealth level. With this objective in mind, government agencies started a funding effort to foster the design, development and implementation of such systems on a wide scale. But the outcomes have not met the expectations set by the resources invested. Multiple elements explain this phenomenon: As it has been frequent with technology, introduction of new surveillance systems to the workflow equation has occurred without taking into consideration the need for understanding and inclusion of deeper personal, psychosocial, organizational and methodological concepts. The environment, in which these systems are operating, is complex, highly dynamic, uncertain, risky, and subject to intense time pressures. Such 'difficult' environments are very challenging to the human as a decision maker. In this paper we will challenge these systems from the perspective of human factors design. We will propose employment of systematic situational awareness research for design and implementation of the next generation publichealthpreparedness infrastructures. We believe that systems designed based on results of such analytical definition of the domain enable publichealth practitioners to effectively collect the most important cues from the environment, process, interpret and understand the information in the context of organizational objectives and immediate tasks at hand, and use that understanding to forecast the short term and long term impact of the events in the safety and well being of the community.

Since 2001, the Centers for Disease Control and Prevention's PublicHealth Emergency Preparedness cooperative agreement has supported state, territorial, and local publichealth departments in preparing for and responding to publichealth emergencies. This conceptual article describes complexities identified and lessons learned in developing community preparedness performance measures for the Centers for Disease Control and Prevention's publichealthpreparedness program. Challenges arose in (a) defining community; (b) measuring meaningful community engagement; and (c) determining a strategy for collecting, aggregating, and analyzing data from diverse state, territorial, and local health departments. This article contributes to prior work describing conceptual challenges in developing standardized measures of performance at the federal level and suggests ways to potentially mitigate general performance measurement challenges as well as measurement complexities specific to community preparedness. It may be informative for those state, territorial, and local health departments currently implementing (or contemplating implementing) community preparedness activities and for individuals more generally engaged in performance measurement. PMID:24322842

Since 2001, the New York City Department of Health and Mental Hygiene (NYC DOHMH) has built a strong publichealthpreparedness foundation, made possible in large part by funding from the PublicHealth Emergency Preparedness (PHEP) Cooperative Agreement provided by the Centers for Disease Control and Prevention. While this funding has allowed NYC DOHMH to make great progress in areas such as all-hazards planning, risk communication, disease surveillance, and lab capacity, the erosion of federal preparedness dollars for all-hazards preparedness has the potential to reverse these gains. Since the initiation of the PHEP grant in 2002, PHEP funding has steadily declined nationwide. Specifically, the total federal allocation has decreased approximately 20%, from $862,777,000 in 2005 to $688,914,546 in 2009. With city and state budgets at an all-time low, federal funding cuts will have a significant impact on publichealthpreparedness programs nationwide. In this time of strict budgetary constraints, the nation would be better served by strategically awarding federal preparedness funds to areas at greatest risk. The absence of risk-based funding in determining PHEP grant awards leaves the nation's highest-risk areas, like New York City, with insufficient resources to prepare for and respond to publichealth emergencies. This article examines the progress New York City has made and what is at stake as federal funding continues to wane. PMID:19821753

American Indian/Alaska Native tribal governments are sovereign entities with inherent authority to create laws and enact health regulations. Laws are an essential tool for ensuring effective publichealth responses to emerging threats. To analyze how tribal laws support publichealth practice in tribal communities, we reviewed tribal legal documentation available through online databases and talked with subject-matter experts in tribal publichealth law. Of the 70 tribal codes we found, 14 (20%) had no clearly identifiable publichealth provisions. The public health–related statutes within the remaining codes were rarely well integrated or comprehensive. Our findings provide an evidence base to help tribal leaders strengthen publichealth legal foundations in tribal communities. PMID:19150897

Currently, publichealth emergency preparedness (PHEP) is not well defined. Discussions about publichealthpreparedness often make little progress, for lack of a shared understanding of the topic. We present a concise yet comprehensive framework describing PHEP activities. The framework, which was refined for 3 years by state and local health departments, uses terms easily recognized by the publichealth workforce within an information flow consistent with the National Incident Management System. To assess the framework's completeness, strengths, and weaknesses, we compare it to 4 other frameworks: the RAND Corporation's PREPARE Pandemic Influenza Quality Improvement Toolkit, the National Response Framework's PublicHealth and Medical Services Functional Areas, the National Health Security Strategy Capabilities List, and the Centers for Disease Control and Prevention's PHEP Capabilities. PMID:22397343

Currently, publichealth emergency preparedness (PHEP) is not well defined. Discussions about publichealthpreparedness often make little progress, for lack of a shared understanding of the topic. We present a concise yet comprehensive framework describing PHEP activities. The framework, which was refined for 3 years by state and local health departments, uses terms easily recognized by the publichealth workforce within an information flow consistent with the National Incident Management System. To assess the framework's completeness, strengths, and weaknesses, we compare it to 4 other frameworks: the RAND Corporation's PREPARE Pandemic Influenza Quality Improvement Toolkit, the National Response Framework's PublicHealth and Medical Services Functional Areas, the National Health Security Strategy Capabilities List, and the Centers for Disease Control and Prevention's PHEP Capabilities. PMID:22397343

... PublicHealthPreparedness and Response: Notice of Charter Renewal This gives notice under the Federal... of PublicHealthPreparedness and Response, Centers for Disease Control and Prevention (CDC... Scientific Counselors, Office of PublicHealthPreparedness and Response, CDC, HHS, 1600 Clifton Road...

... PublicHealthPreparedness and Response: Notice of Charter Renewal This gives notice under the Federal... of PublicHealthPreparedness and Response, Centers for Disease Control and Prevention (CDC... Scientific Counselors, Office of PublicHealthPreparedness and Response, CDC, HHS, 1600 Clifton Road,...

The Centers for Disease Control and Prevention's PublicHealth Practice Program Office has issued a PublicHealthPreparedness and Response Capacity Inventory to help state and local publichealth systems assess their progress towards achievement of the critical capacities and benchmarks specified in the federal Supplemental Funds for PublicHealthPreparedness and Response for Bioterrorism. The criterion validity of the capacity inventory was assessed by comparing selected state and local agency responses with documentation provided by the agencies to corroborate their answers. Content validity assessment took the form of a mailed survey that also identified the most important questions from the perspective of a separate set of state and local officials. Responses generally upheld the validity of the capacity inventory, although circumstantial threats to validity were identified in the testing process. The instrument's use has been reported to the Centers for Disease Control and Prevention by approximately half the states and over 800 local publichealth entities. An interactive electronic version includes a scoring mechanism that allows agencies to judge progress towards the critical capacities and benchmarks over time. PMID:15253518

The terrorist attacks on 11 September 2001 and the deliberate release of anthrax in the United States had consequences for publichealth not only there, but also in Europe. Europe's publichealth systems had to manage numerous postal materials possibly contaminated with anthrax. Our survey aimed to document the response of European publichealth institutes to recent bioterrorist events to identify the gaps that need to be addressed; 18 institutes from 16 countries participated in this Euroroundup. Bioterrorist threats in Europe were hoaxes only, and should be considered as a "preparedness exercise" from which three lessons can be drawn. Firstly, because of inadequate preparedness planning and funding arrangements, Europe was not ready in October 2001 to respond to bioterrorism. Secondly, although European institutes reacted quickly and adapted their priorities to a new type of threat, they need adequate and sustained support from national governments to maintain their overall capacity. Thirdly, the recent crisis demonstrated the need for increased investment in epidemiology training programmes and the establishment of a technical coordination unit for international surveillance and outbreak response in the European Union. PMID:11891386

Health care providers and their legal counsel play pivotal roles in preparing for and responding to publichealth emergencies. Lawyers representing hospitals, health systems, and other health care provider components are being called upon to answer complex legal questions regarding publichealthpreparedness issues that most providers have not previously faced. Many of these issues are legal issues with which publichealth officials should be familiar, and that can serve as a starting point for cross-sector legal preparedness planning involving both the publichealth and health care communities. This article examines legal issues that health care providers face in preparing for publichealth emergencies, and steps that providers, their legal counsel, and others can take to address those issues and to strengthen community preparedness. PMID:18388658

... PublicHealthPreparedness and Response, Board of Scientific Counselors (BSC OPHPR) In accordance with... Control and Prevention (CDC), and the Director, Office of PublicHealthPreparedness and Response (OPHPR... Address Contact Person for More Information: Marquita Black, Office of Science and PublicHealth...

Comparative case studies found that regionalization originated from a crisis or perceived need for a coordinated response, a need to build local publichealth capacity, or an effort to use federal preparedness funds more efficiently. Regions vary in terms of their congruence with regional structures for partner agencies, such as emergency management agencies, as well as hospital and health services markets and organizational structure. Some focus on building formal organizational relationships to coordinate and sometimes standardize preparedness and response activities or build regional capacity, while others focus on building informal professional networks. Whatever the approach, strong leadership and trust are required for effective planning, emergency response, and sustainability. This article suggests that regionalization improves emergency preparedness by allowing for more efficient use of resources and better coordination and demonstrated progress in terms of planning and coordination; regional capacity-building, training, and exercises; and development of professional networks. PMID:18763406

In 2008, at the request of the Centers for Disease Control and Prevention (CDC), the Institute of Medicine (IOM) prepared a report identifying knowledge gaps in publichealth systems preparedness and emergency response and recommending near-term priority research areas. In accordance with the Pandemic and All-Hazards Preparedness Act mandating new publichealth systems research for preparedness and emergency response, CDC provided competitive awards establishing nine Preparedness and Emergency Response Research Centers (PERRCs) in accredited U.S. schools of publichealth. The PERRCs conducted research in four IOM-recommended priority areas: (1) enhancing the usefulness of publichealthpreparedness and response (PHPR) training, (2) creating and maintaining sustainable preparedness and response systems, (3) improving PHPR communications, and (4) identifying evaluation criteria and metrics to improve PHPR for all hazards. The PERRCs worked closely with state and local publichealth, community partners, and advisory committees to produce practice-relevant research findings. PERRC research has generated more than 130 peer-reviewed publications and nearly 80 practice and policy tools and recommendations with the potential to significantly enhance our nation's PHPR to all hazards and that highlight the need for further improvements in publichealth systems. PMID:25355970

Smallpox is an acute, febrile, contagious disease caused by the Variola virus, which is a member of the Poxviridae family. Until the 1970s, smallpox had been a pandemic disease for more than 3000 years, endemic in tropical and developing areas and periodically epidemic worldwide. The World Health Organization declared smallpox to be completely eradicated in 1980 as the result of global vaccination efforts. At that time, all routine vaccination programs were terminated, given the success of thismonumental eradication. Although smallpox remains fully eradicated, uncertainty exists regarding the possibility of recurrent smallpox outbreaks. At the end of the Cold War, concerns regarding unstable international security and the feasibility of terrorism with weapons of mass destruction have been highlighted. The potential threat of intentional release of smallpox has forced regional health authorities to reconsider their political landscape and create preparedness plans to protect the community in the event of biological attacks. Here we present current countermeasures to this biological threat in Japan and discuss methods for strengthening publichealthpreparedness both domestically and internationally. These methods include infection control, vaccination policy, and international partnerships to help deter or contain a contagious smallpox pandemic. PMID:26060873

... PublicHealthPreparedness and Response (BSC, OPHPR) In accordance with section 10 (a) (2) of the Federal... Disease Control and Prevention (CDC), and the Director, Office of PublicHealthPreparedness and Response... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH...

... PublicHealthPreparedness and Response; Meeting In accordance with section 10 (a) (2) of the Federal... Prevention (CDC), and the Director, Office of PublicHealthPreparedness and Response (OPHPR), concerning... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH...

... PublicHealthPreparedness and Response (BSC, OPHPR) In accordance with section 10(a)(2) of the Federal... Disease Control and Prevention (CDC), and the Director, Office of PublicHealthPreparedness and Response... From the Federal Register Online via the Government Publishing Office ] DEPARTMENT OF HEALTH...

... PublicHealthPreparedness and Response (BSC, OPHPR) In accordance with section 10(a)(2) of the Federal... Disease Control and Prevention (CDC), and the Director, Office of PublicHealthPreparedness and Response... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH...

... PublicHealthPreparedness and Response (BSC, OPHPR) In accordance with section 10 (a)(2) of the Federal..., Office of PublicHealthPreparedness and Response (OPHPR), concerning strategies and goals for the... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH...

In response to the attack of 11 September 2001 on the USA, World Health Organization (WHO), Regional Office for Europe took immediate steps in order to be able to assist countries in case of a terrorist attack. Among other things, WHO organised a series of different consultations with international organisations, government representatives and experts in order to assess the state of preparedness at the national and international levels, to identify the main problems and to make recommendations. The problems were addressed in the context of possible publichealth consequences, regardless of whether such an incident derived from a deliberate act or a naturally occurring event. This overview gives a brief account of presentation made at the European Union "First Civil Protection Forum", which was held in Brussels in November 2002, and which served as a basis for defining the EU priorities and actions to make Europe a safer place to live. PMID:14679666

Efforts to respond to performance-based accountability mandates for publichealth emergency preparedness have been hindered by a weak evidence base linking preparedness activities with response outcomes. We describe an approach to measure development that was successfully implemented in the Centers for Disease Control and Prevention PublicHealth Emergency Preparedness Cooperative Agreement. The approach leverages insights from process mapping and experts to guide measure selection, and provides mechanisms for reducing performance-irrelevant variation in measurement data. Also, issues are identified that need to be addressed to advance the science of measurement in publichealth emergency preparedness. PMID:24229520

Recent natural and human-caused disasters have awakened publichealth officials to the importance of emergency preparedness. Guided by health behavior and media effects theories, the analysis of a statewide survey in Georgia reveals that self-efficacy, subjective norm, and emergency news exposure are positively associated with the respondents' possession of emergency items and their stages of emergency preparedness. Practical implications suggest less focus on demographics as the sole predictor of emergency preparedness and more comprehensive measures of preparedness, including both a person's cognitive stage of preparedness and checklists of emergency items on hand. We highlight the utility of theory-based approaches for understanding and predicting public emergency preparedness as a way to enable more effective health and risk communication. PMID:20574880

Many publichealth departments seek to improve their capability to respond to large-scale events such as an influenza pandemic. Quality improvement (QI), a structured approach to improving performance, has not been widely applied in publichealth. We developed and tested a pilot QI collaborative to explore whether QI could help publichealth departments improve their pandemic preparedness. We demonstrated that this is a promising model for improving publichealthpreparedness and may be useful for improving publichealth performance overall. Further efforts are needed, however, to encourage the robust implementation of QI in publichealth. PMID:18628274

The contribution of publichealth officers is of crucial importance in both the preparedness planning process and the response to health threats since the implementation of publichealth measures lies within the competence of the publichealth system. Thus, publichealth officers on regional and district level have to be involved in every stage of the planning process for crisis management. Federal structures of health systems as equivalent to the political structure of a country pose specific challenges for both the planning process and the response itself. The most important instrument for the evaluation of crisis plans, including the assessment of the publichealth officers' preparedness, is the performance of exercises. The success of a simulation exercise depends mainly on careful planning process, clear evaluation criteria and a work plan, that allows for necessary improvements of crisis plans of all involved organisations. Simulation exercises are an integrated element of preparedness activities on all administrative levels of the publichealth system. Depending on the nature of the exercise publichealth officers on regional and district level are involved as planners or as players PMID:18768125

... PublicHealthPreparedness and Response, (BSC, OPHPR) In accordance with section 10(a)(2) of the Federal... Director, Centers for Disease Control and Prevention (CDC), and the Director, Office of PublicHealth... Science and PublicHealth Practice, Executive Assistant, Centers for Disease Control and Prevention,...

We outline a conceptual framework developed to meet the needs of publichealth professionals in the province of Ontario for incident management system-related education and training. By using visual models, this framework applies a publichealth lens to emergency management, introducing concepts relevant to publichealth and thereby shifting the focus of emergency preparedness from a strict "doctrine" to a more dynamic and flexible approach grounded in the traditional principles of incident management systems. These models provide a foundation for further exploration of the theoretical foundations for publichealth emergency preparedness in practice. PMID:25991506

Post-9/11, preparedness planning has catalyzed intrastate regionalization of local publichealth resources throughout the United States. Investigating this trend unveils several regionalization themes, relevant in other sectors of government, which are applicable to local publichealth. In this review article, we begin by briefly examining the lessons learned from regionalization for police and fire services, drawing comparisons to publichealth. Then we provide a brief history of the accelerating regionalization of local publichealth services sparked by the current attention to emergency preparedness. In particular, we offer case studies from Massachusetts and the National Capital Region to highlight examples of regionalization outcomes related to networking, coordination, standardization, and centralization of publichealth services. The impact of social capital on preparedness is also explored. Finally, we summarize research needs for the future. PMID:18348711

September 11 and the subsequent anthrax attacks marked the beginning of significant investment by the federal government to develop a national publichealth emergency response capability. Recognizing the importance of the publichealth sector's contribution to the burgeoning homeland security enterprise, this investment was intended to convey a "dual benefit" by strengthening the overall publichealth infrastructure while building preparedness capabilities. In many instances, federal funds were used successfully for preparedness activities. For example, electronic health information networks, a Strategic National Stockpile, and increased interagency cooperation have all contributed to creating a more robust and prepared enterprise. Additionally, the knowledge of rarely seen or forgotten pathogens has been regenerated through newly established publichealth learning consortia, which, too, have strengthened relationships between the practice and academic communities. Balancing traditional publichealth roles with new preparedness responsibilities heightened publichealth's visibility, but it also presented significant complexities, including expanded lines of reporting and unremitting inflows of new guidance documents. Currently, a rapidly diminishing publichealth infrastructure at the state and local levels as a result of federal budget cuts and a poor economy serve as significant barriers to sustaining these nascent federal publichealthpreparedness efforts. Sustaining these improvements will require enhanced coordination, collaboration, and planning across the homeland security enterprise; an infusion of innovation and leadership; and sustained transformative investment for governmental publichealth. PMID:22455679

During a publichealth crisis, publichealth agencies engage in a variety of public communication efforts to inform the population, encourage the adoption of preventive behaviors, and limit the impact of adverse events. Given the importance of communication to the public in publichealth emergency preparedness, it is critical to examine the extent to which this field of study has received attention from the scientific community. We conducted a systematic literature review to describe current research in the area of communication to the public in publichealth emergency preparedness, focusing on the association between sociodemographic and behavioral factors and communication as well as preparedness outcomes. Articles were searched in PubMed and Embase and reviewed by 2 independent reviewers. A total of 131 articles were included for final review. Fifty-three percent of the articles were empirical, of which 74% were population-based studies, and 26% used information environment analysis techniques. None had an experimental study design. Population-based studies were rarely supported by theoretical models and mostly relied on a cross-sectional study design. Consistent results were reported on the association between population socioeconomic factors and publichealth emergency preparedness communication and preparedness outcomes. Our findings show the need for empirical research to determine what type of communication messages can be effective in achieving preparedness outcomes across various population groups. They suggest that a real-time analysis of the information environment is valuable in knowing what is being communicated to the public and could be used for course correction of publichealth messages during a crisis. PMID:24041193

Responding to agricultural bioterrorism with pathogenic agents that are communicable from animals to humans (zoonotic diseases) requires effective coordination of many organizations, both inside and outside of government. Action must be simultaneously taken to address publichealth concerns, respond to the agricultural dimensions of the event, and carry out the necessary law enforcement investigation. As part of a project focused on examining publichealthpreparedness in Georgia, an exercise was carried out in July 2005 examining the intentional introduction of avian influenza (H5N1) in commercial poultry operations. The attack scenario, which was written to occur during an already severe human influenza season, enabled exploration of a range of issues associated with publichealthpreparedness for major disease outbreaks including pandemic influenza, coordination of a multiagency response operation at multiple levels of government, and effective management of interdisciplinary response activities. The exercise is described and broader policy lessons regarding preparedness planning are discussed. PMID:16999589

Emerging infectious diseases pose a growing threat to human populations. Many of the world's epidemic diseases (particularly those transmitted by intermediate hosts) are known to be highly sensitive to long-term changes in climate and short-term fluctuations in the weather. The application of environmental data to the study of disease offers the capability to demonstrate vector-environment relationships and potentially forecast the risk of disease outbreaks or epidemics. Accurate disease forecasting models would markedly improve epidemic prevention and control capabilities. This chapter examines the potential for epidemic forecasting and discusses the issues associated with the development of global networks for surveillance and prediction. Existing global systems for epidemic preparedness focus on disease surveillance using either expert knowledge or statistical modelling of disease activity and thresholds to identify times and areas of risk. Predictive health information systems would use monitored environmental variables, linked to a disease system, to be observed and provide prior information of outbreaks. The components and varieties of forecasting systems are discussed with selected examples, along with issues relating to further development.

Emerging infectious diseases pose a growing threat to human populations. Many of the world’s epidemic diseases (particularly those transmitted by intermediate hosts) are known to be highly sensitive to long-term changes in climate and short-term fluctuations in the weather. The application of environmental data to the study of disease offers the capability to demonstrate vector–environment relationships and potentially forecast the risk of disease outbreaks or epidemics. Accurate disease forecasting models would markedly improve epidemic prevention and control capabilities. This chapter examines the potential for epidemic forecasting and discusses the issues associated with the development of global networks for surveillance and prediction. Existing global systems for epidemic preparedness focus on disease surveillance using either expert knowledge or statistical modelling of disease activity and thresholds to identify times and areas of risk. Predictive health information systems would use monitored environmental variables, linked to a disease system, to be observed and provide prior information of outbreaks. The components and varieties of forecasting systems are discussed with selected examples, along with issues relating to further development. PMID:10997211

The unanticipated global outbreak of Zika virus infection is the most current but certainly not the last emerging infectious disease challenge to confront the US public heath system. Despite a number of such threats in recent years, significant gaps remain in core areas of publichealth system readiness. Stable, sustained investments are required to establish a solid foundation for achieving necessary national publichealth emergency preparedness and response capacity. PMID:26952646

Background Health care providers (HCPs) play an important role in publichealth emergency preparedness and response (PHEPR) so need to be aware of publichealth threats and emergencies. To inform HCPs, publichealth issues PHEPR messages that provide guidelines and updates, and facilitate surveillance so HCPs will recognize and control communicable diseases, prevent excess deaths and mitigate suffering. Publichealth agencies need to know that the PHEPR messages sent to HCPs reach their target audience and are effective and informative. Publichealth agencies need to know that the PHEPR messages sent to HCPs reach their target audience and are effective and informative. We conducted a literature review to investigate the systems and tools used by publichealth to generate PHEPR communications to HCPs, and to identify specific characteristics of message delivery mechanisms and formats that may be associated with effective PHEPR communications. Methods A systematic review of peer- and non-peer-reviewed literature focused on the following questions: 1) What publichealth systems exist for communicating PHEPR messages from publichealth agencies to HCPs? 2) Have these systems been evaluated and, if yes, what criteria were used to evaluate these systems? 3) What have these evaluations discovered about characterizations of the most effective ways for publichealth agencies to communicate PHEPR messages to HCPs? Results We identified 25 systems or tools for communicating PHEPR messages from publichealth agencies to HCPs. Few articles assessed PHEPR communication systems or messaging methods or outcomes. Only one study compared the effectiveness of the delivery format, device or message itself. We also discovered that the potential is high for HCPs to experience "message overload" given redundancy of PHEPR messaging in multiple formats and/or through different delivery systems. Conclusions We found that detailed descriptions of PHEPR messaging from publichealth to HCPs

Background Exercises are increasingly common tools used by the health sector and other sectors to evaluate their preparedness to respond to publichealth threats. Exercises provide an opportunity for multiple sectors to practice, test and evaluate their response to all types of publichealth emergencies. The information from these exercises can be used to refine and improve preparedness plans. There is a growing body of literature about the use of exercises among local, state and federal publichealth agencies in the United States. There is much less information about the use of exercises among publichealth agencies in other countries and the use of exercises that involve multiple countries. Results We developed and conducted 12 exercises (four sub-national, five national, three sub-regional) from August 2006 through December 2008. These 12 exercises included 558 participants (average 47) and 137 observers (average 11) from 14 countries. Participants consistently rated the overall quality of the exercises as very good or excellent. They rated the exercises lowest on their ability to identifying key gaps in performance. The vast majority of participants noted that they would use the information they gained at the exercise to improve their organization’s preparedness to respond to an influenza pandemic. Participants felt the exercises were particularly good at raising awareness and understanding about publichealth threats, assisting in evaluating plans and identifying priorities for improvement, and building relationships that strengthen preparedness and response across sectors and across countries. Participants left the exercises with specific ideas about the most important actions that they should engage in after the exercise such as improved planning coordination across sectors and countries and better training of health workers and response personnel. Conclusions These experiences suggest that exercises can be a valuable, low-burden tool to improve emergency

The Bandar Bushehr, Iran earthquake of April 9, 2013 gravely illustrates how disaster-prone areas of the world are compounding their risk of disaster and major publichealth emergencies when there is a geographical convergence of natural and technological hazards. Scientists must emphasize to policy makers that ever-increasing regional industrialization and the broader introduction of nuclear facilities, especially in the Middle East, must parallel sound prevention and community-level publichealthpreparedness planning. PMID:23962385

Objective To study the relationship between elements of publichealth infrastructure and local publichealth emergency preparedness (PHEP). Data Sources/Study Setting National Association of County and City Health Officials 2005 National Profile of Local Health Departments (LHDs). Study Design Cross-sectional. Principal Findings LHDs serving larger populations are more likely to have staff, capacities, and activities in place for an emergency. Adjusting for population size, the presence of a local board of health and the LHDs' experience in organizing PHEP coalitions were associated with better outcomes. Conclusions The results of this study suggest that more research should be conducted to investigate the benefit of merging small health departments into coalitions to overcome the inverse relationship between preparedness and population size of the jurisdiction served by the LHD. PMID:19686254

The City of Milwaukee Health Department piloted a short-term, near real-time syndromic surveillance and communication tool by using an existing secure regional Internet infrastructure. Voluntary, active syndromic case reporting by hospital Emergency Departments was combined with other data streams, including clinical laboratory reports of communicable disease, hospital emergency room diversions, ambulance runs, medical examiner reports of unusual or suspicious deaths, poison control and nursing hotline call volumes, and pharmacy over-the-counter sales. These data were aggregated into a "Surveillance Dashboard" format that was used to communicate community syndromic health trends to hospitals, Emergency Departments, and other providers using a secure Internet technology. Emergency Departments at 8 area hospitals reported a total of 314 cases meeting syndromic criteria from 26,888 patient encounters. Participants were satisfied with data entry and communications. All participating Emergency Departments received e-mail and text pager alerts sent by the Milwaukee Health Department. No unexplained findings or suggestions of an early outbreak were reported through syndrome surveillance for the 4-week duration of the project. Similar surveillance and communications systems could provide multiple benefits to Emergency Department workflow and management, as well as to publichealth and emergency response. PMID:15253519

The globalization of publichealth is both real and relevant throughout the United States and to Americans traveling or residing abroad. US public policy responses are evolving, but a crisper and more comprehensive global perspective is needed. I suggest four timely US actions to address today’s competing realities of globalization and economic austerity: raise awareness among clinicians and local health departments; capture and share exemplary disaster management practices across countries; ensure that US global health investments are effective, efficient, and sustainable; and think globally while acting locally to enhance US health security. The reauthorization of the Pandemic and All-Hazards Preparedness Act of 2006 provides an opportunity to more clearly address the global dimensions of domestic preparedness. PMID:22515870

When disasters and other broad-scale publichealth emergencies occur in the United States, they often reveal flaws in the pre-event preparedness of those individuals and agencies charged with responsibility for emergency response and recovery activities. A significant contributor to this problem is the unwillingness of some publichealth workers to participate in the requisite planning, training, and response activities to ensure quality preparedness. The thesis of this article is that there are numerous, empirically supported models of behavior change that hold potential for motivating role-appropriate behavior in publichealth professionals. The models that are highlighted here for consideration and prospective adaptation to the publichealth emergency preparedness system (PHEPS) are the Transtheoretical Model of Intentional Behavior Change (TTM) and Motivational Interviewing (MI). Core concepts in TTM and MI are described, and specific examples are offered to illustrate the relevance of the frameworks for understanding and ameliorating PHEPS-based workforce problems. Finally, the requisite steps are described to ensure the readiness of organizations to support the implementation of the ideas proposed. PMID:22916453

Meeting the needs of publichealth emergency and response presents a unique challenge for health practitioners with primary responsibilities for rural communities that are often very diverse. The present study assessed the language capabilities, confidence and training needs of Texas rural physicians in responding to publichealth emergencies. In the first half of year 2004, a cross-sectional, semistructured survey questionnaire was administered in northern, rural Texas. The study population consisted of 841 practicing or retired physicians in the targeted area. One-hundred-sixty-six physicians (30%) responded to the survey. The responses were geographically referenced in maps. Respondents reported seeing patients with diverse cultural backgrounds. They communicated in 16 different languages other than English in clinical practice or at home, with 40% speaking Spanish at work. Most were not confident in the diagnosis or treatment of publichealth emergency cases. Geographic information systems were found useful in identifying those jurisdictions with expressed training and cultural needs. Additional efforts should be extended to involve African-American/Hispanic physicians in preparedness plans for providing culturally and linguistically appropriate care in emergencies. PMID:17128688

Objectives. We explored the relationship between the preparedness of master of publichealth (MPH) graduates in publichealth law and ethics and their completion of courses in these areas. Methods. We reviewed accredited publichealth schools and programs to assess the supply of required and elective courses in law and ethics. In addition, we conducted an Internet-based scenario survey of MPH graduates. Survey results were analyzed, and relationships between scenario responses and completion of law and ethics courses were assessed. Results. Of the 93 programs and schools reviewed, 14% required a course in ethics and 16% required a course in law. The majority (range = 55%–76%) of the survey respondents indicated being “prepared” or “very prepared” for each of the 9 publichealth scenarios. There were no significant relationships between scenario responses and completion of an ethics course. Responses to 2 scenarios (one involving food code violations and one involving a prison population) were significantly related to participants' completion of a course in law. Conclusions. Few publichealth schools and programs require graduate courses in ethics and law. Most MPH graduates report being prepared to address publichealth challenges. Additional research is necessary to improve techniques for measuring preparedness. PMID:18633077

In February 2007, Indonesia withheld sharing H5N1 viral samples in order to compel the World Health Organization and Member States to guarantee future access to vaccines for States disproportionately burdened by infectious diseases. This article explores conceptual and temporal fallacies in the International Health Regulations (2005) and the Doha Declaration on the TRIPS Agreement and PublicHealth, as relates to global publichealthpreparedness. Recommendations include adopting laws to facilitate non-pharmaceutical interventions; securing the rights of affected populations; and fostering inter-State collaborations to promote intra-State publichealth capacity building. PMID:18076510

Objective. To estimate pharmaceutical emergency preparedness of US states and commonwealth territories. Methods. A quantitative content analysis was performed to evaluate board of pharmacy legal documents (ie, statutes, rules, and regulations) for the presence of the 2006 Rules for PublicHealth Emergencies (RPHE) from the National Association of Boards of Pharmacy's (NABP) Model Pharmacy Practice Act. Results. The median number of state-adopted RPHE was one, which was significantly less than the hypothesized value of four. Rule Two, which recommended policies and procedures for reporting disasters, was adopted significantly more than other RPHE. Ten states incorporated language specific to publichealth emergency refill dispensing, and among these, only six allowed 30-day refill quantities. Conclusion. Based on the 2006 NABP model rules, it does not appear that states are prepared to expedite an effective pharmaceutical response during a publichealth emergency. Boards of pharmacy should consider adding the eight RPHE to their state pharmacy practice acts. PMID:27073273

Objective. To estimate pharmaceutical emergency preparedness of US states and commonwealth territories. Methods. A quantitative content analysis was performed to evaluate board of pharmacy legal documents (ie, statutes, rules, and regulations) for the presence of the 2006 Rules for PublicHealth Emergencies (RPHE) from the National Association of Boards of Pharmacy’s (NABP) Model Pharmacy Practice Act. Results. The median number of state-adopted RPHE was one, which was significantly less than the hypothesized value of four. Rule Two, which recommended policies and procedures for reporting disasters, was adopted significantly more than other RPHE. Ten states incorporated language specific to publichealth emergency refill dispensing, and among these, only six allowed 30-day refill quantities. Conclusion. Based on the 2006 NABP model rules, it does not appear that states are prepared to expedite an effective pharmaceutical response during a publichealth emergency. Boards of pharmacy should consider adding the eight RPHE to their state pharmacy practice acts. PMID:27073273

Populations affected by disaster increase the demand on emergency response and publichealth systems and on acute care hospitals, often causing disruptions of services. Household preparedness measures, such as having a 3-day supply of food, water, and medication and a written household evacuation plan, can improve a population's ability to cope with service disruption, decreasing the number of persons who might otherwise overwhelm emergency services and health-care systems. To estimate current levels of self-reported household preparedness by state and sociodemographic characteristics, CDC analyzed Behavioral Risk Factor Surveillance System (BRFSS) survey data collected in 14 states during 2006-2010. The results of this analysis indicated that an estimated 94.8% of households had a working battery-operated flashlight, 89.7% had a 3-day supply of medications for everyone who required them, 82.9% had a 3-day supply of food, 77.7% had a working battery-operated radio, 53.6% had a 3-day supply of water, and 21.1% had a written evacuation plan. Non-English speaking and minority respondents, particularly Hispanics, were less likely to report household preparedness for an emergency or disaster, suggesting that more outreach activities should be directed toward these populations. PMID:22971743

To date, Australia has not had to respond to a nationwide catastrophic event. However, over the past decade, heat waves, bushfires, cyclones, and floods have significantly challenged Australia's disaster preparedness and the surge capacity of local and regional health systems. Given that disaster events are predicted to increase in impact and frequency, the health workforce needs to be prepared for and able to respond effectively to a disaster. To be effective, nurses must be clear regarding their role in a disaster and be able to articulate the value and relevance of this role to communities and the professionals they work with. Since almost all disasters will exert some impact on publichealth, it is expedient to prepare the publichealth nursing workforce within Australia. This paper highlights issues currently facing disaster nursing and focuses on the challenges for Australian publichealth nurses responding to and preparing for disasters within Australia. The paper specifically addresses publichealth nurses' awareness regarding their roles in disaster preparation and response, given their unique skills and central position in publichealth. PMID:24635900

Rapid advances in telehealth development and adoption are increasing the spectrum of information and communication technologies that can be applied not only to individual patient care but more broadly to population health as well. Participants in this breakout session were asked to address, from their diverse perspectives, a series of questions relating to the current and potential uses of telehealth applications and networks for publichealth and emergency/disaster preparedness and response systems. Participants identified several gaps in current understanding and research emphasis. There is a clear need for more and larger outcome studies to assess the impact and cost benefit of telehealth applications in terms of improving publichealth at the population and community levels. In addition, more research is needed to demonstrate the ability of telehealth tools and technologies to facilitate and extend the reach of major national clinical and publichealth research initiatives. Perhaps most importantly, the National Institutes of Health should develop and/or strengthen strategic partnerships with other funding agencies with overlapping or complementary interests to accelerate interdisciplinary research in this rapidly evolving but relatively understudied and complex field. PMID:20043703

Objective To assess the emergency preparedness knowledge, behaviors, and training needs of families of children with developmental disabilities (DD). Design An online survey. Participants A sample of 314 self-selecting US parents/guardians of children with DD, aged birth-21 years. Main outcome measures 1) Preparedness self-assessment; 2) self-report regarding the extent to which families followed 11 specific preparedness action steps derived from publicly available preparedness guides; and 3) parent training and support needs. Results Although most participants assessed themselves to be somewhat to moderately well prepared, even those who reported being “very well prepared” had taken fewer than half of 11 recommended action steps. Most participants expressed a need for preparedness support; virtually all the respondents felt that training was either important or very important. Conclusions Children with disabilities are known to be particularly vulnerable to negative disaster impacts. Overall, parents in this study appeared under-prepared to meet family disaster needs, although they recognized its importance. The results suggest opportunities and methods for publichealth and safety planning, education and outreach to parents of children with DD who would benefit from targeted training such as information and skill building to develop effective family preparedness plans and connections to local emergency management and responders. PMID:25779895

Background Governments may be overwhelmed by a large-scale publichealth emergency, such as a massive bioterrorist attack or natural disaster, requiring collaboration with businesses and other community partners to respond effectively. In Georgia, publichealth officials and members of the Business Executives for National Security have successfully collaborated to develop and test procedures for dispensing medications from the Strategic National Stockpile. Lessons learned from this collaboration should be useful to other publichealth and business leaders interested in developing similar partnerships. Methods The authors conducted a case study based on interviews with 26 government, business, and academic participants in this collaboration. Results The partnership is based on shared objectives to protect publichealth and assure community cohesion in the wake of a large-scale disaster, on the recognition that acting alone neither publichealth agencies nor businesses are likely to manage such a response successfully, and on the realization that business and community continuity are intertwined. The partnership has required participants to acknowledge and address multiple challenges, including differences in business and government cultures and operational constraints, such as concerns about the confidentiality of shared information, liability, and the limits of volunteerism. The partnership has been facilitated by a business model based on defining shared objectives, identifying mutual needs and vulnerabilities, developing carefully-defined projects, and evaluating proposed project methods through exercise testing. Through collaborative engagement in progressively more complex projects, increasing trust and understanding have enabled the partners to make significant progress in addressing these challenges. Conclusion As a result of this partnership, essential relationships have been established, substantial private resources and capabilities have been engaged in

Resilience and the ability to mitigate the consequences of a nuclear incident are enhanced by (1) effective planning, preparation and training; (2) ongoing interaction, formal exercises, and evaluation among the sectors involved; (3) effective and timely response and communication; and (4) continuous improvements based on new science, technology, experience and ideas. Publichealth and medical planning require a complex, multi-faceted systematic approach involving federal, state, local, tribal and territorial governments, private sector organizations, academia, industry, international partners, and individual experts and volunteers. The approach developed by the U.S. Department of Health and Human Services Nuclear Incident Medical Enterprise (NIME) is the result of efforts from government and nongovernment experts. It is a “bottom-up” systematic approach built on the available and emerging science that considers physical infrastructure damage, the spectrum of injuries, a scarce resources setting, the need for decision making in the face of a rapidly evolving situation with limited information early on, timely communication and the need for tools and just-in-time information for responders who will likely be unfamiliar with radiation medicine and uncertain and overwhelmed in the face of the large number of casualties and the presence of radioactivity. The components of NIME can be used to support planning for, response to, and recovery from the effects of a nuclear incident. Recognizing that it is a continuous work-in-progress, the current status of the publichealth and medical preparedness and response for a nuclear incident is provided. PMID:25551496

Resilience and the ability to mitigate the consequences of a nuclear incident are enhanced by (1) effective planning, preparation and training; (2) ongoing interaction, formal exercises, and evaluation among the sectors involved; (3) effective and timely response and communication; and (4) continuous improvements based on new science, technology, experience, and ideas. Publichealth and medical planning require a complex, multi-faceted systematic approach involving federal, state, local, tribal, and territorial governments; private sector organizations; academia; industry; international partners; and individual experts and volunteers. The approach developed by the U.S. Department of Health and Human Services Nuclear Incident Medical Enterprise (NIME) is the result of efforts from government and nongovernment experts. It is a "bottom-up" systematic approach built on the available and emerging science that considers physical infrastructure damage, the spectrum of injuries, a scarce resources setting, the need for decision making in the face of a rapidly evolving situation with limited information early on, timely communication, and the need for tools and just-in-time information for responders who will likely be unfamiliar with radiation medicine and uncertain and overwhelmed in the face of the large number of casualties and the presence of radioactivity. The components of NIME can be used to support planning for, response to, and recovery from the effects of a nuclear incident. Recognizing that it is a continuous work-in-progress, the current status of the publichealth and medical preparedness and response for a nuclear incident is provided. PMID:25551496

Background Publichealth legal preparedness (PHLP) for emergencies is a core component of the health system response. However, the implementation of health legal preparedness differs between low- and middle-income countries (LMIC) and developed countries. Objective This paper examines recent trends regarding publichealth legal preparedness for emergencies and discusses its role in the recent Ebola outbreak. Design A rigorous literature review was conducted using eight electronic databases as well as Google Scholar. The results encompassed peer-reviewed English articles, reports, theses, and position papers dating from 2011 to 2014. Earlier articles concerning regulatory actions were also examined. Results The importance of PHLP has grown during the past decade and focuses mainly on infection–disease scenarios. Amid LMICs, it mostly refers to application of international regulations, whereas in developed states, it focuses on independent legislation and creation of conditions optimal to promoting an effective emergency management. Among developed countries, the United States’ utilisation of health legal preparedness is the most advanced, including the creation of a model comprising four elements: law, competencies, information, and coordination. Only limited research has been conducted in this field to date. Nevertheless, in both developed and developing states, studies that focused on regulations and laws activated in health systems during emergencies, identified inconsistency and incoherence. The Ebola outbreak plaguing West Africa since 2014 has global implications, challenges and paralleling results, that were identified in this review. Conclusions The review has shown the need to broaden international regulations, to deepen reciprocity between countries, and to consider LMICs health capacities, in order to strengthen the national health security. Adopting elements of the health legal preparedness model is recommended. PMID:26449204

Publichealth readiness has increased at all jurisdictional levels because of increased sensitivity to threats. Since 2001, with billions of dollars invested to bolster the publichealth system’s capacity, the public expects that publichealth will identify the etiology of and respond to events more rapidly. However, when etiologies are unknown at the onset of the investigation but interventions must be implemented, publichealth practitioners must benefit from past investigations’ lessons to strengthen preparedness for emerging threats. We have identified such potentially actionable lessons learned from historically important publichealth events that occurred primarily as syndromes for which the etiological agent initially was unknown. Ongoing analysis of investigations can advance our capability to recognize and investigate syndromes and other problems and implement the most appropriate interventions. PMID:22571706

Publichealth readiness has increased at all jurisdictional levels because of increased sensitivity to threats. Since 2001, with billions of dollars invested to bolster the publichealth system's capacity, the public expects that publichealth will identify the etiology of and respond to events more rapidly. However, when etiologies are unknown at the onset of the investigation but interventions must be implemented, publichealth practitioners must benefit from past investigations' lessons to strengthen preparedness for emerging threats. We have identified such potentially actionable lessons learned from historically important publichealth events that occurred primarily as syndromes for which the etiological agent initially was unknown. Ongoing analysis of investigations can advance our capability to recognize and investigate syndromes and other problems and implement the most appropriate interventions. PMID:22571706

Agents of opportunity (AO) in academic medical centers (AMC) are defined as unregulated or lightly regulated substances used for medical research or patient care that can be used as "dual purpose" substances by terrorists to inflict damage upon populations. Most of these agents are used routinely throughout AMC either during research or for general clinical practice. To date, the lack of careful regulations for AOs creates uncertain security conditions and increased malicious potential. Using a consensus-based approach, we collected information and opinions from staff working in an AMC and 4 AMC-affiliated hospitals concerning identification of AO, AO attributes, and AMC risk and preparedness, focusing on AO security and dissemination mechanisms and likely hospital response. The goal was to develop a risk profile and framework for AO in the institution. Agents of opportunity in 4 classes were identified and an AO profile was developed, comprising 16 attributes denoting information critical to preparedness for AO misuse. Agents of opportunity found in AMC present a unique and vital gap in publichealthpreparedness. Findings of this project may provide a foundation for a discussion and consensus efforts to determine a nationally accepted risk profile framework for AO. This foundation may further lead to the implementation of appropriate regulatory policies to improve publichealthpreparedness. Agents of opportunity modeling of dissemination properties should be developed to better predict AO risk. PMID:21149234

This article reports on the design, evaluation framework, and results from the Meta-Leadership Summit for Preparedness Initiative. The Meta-Leadership Summit for Preparedness was a 5-year initiative based on the premise that national preparedness and emergency response is not solely the responsibility of government. From 2006 to 2011, 36 Meta-Leadership Summits were delivered in communities across the country. Summits were customized, 10-hour leadership development, networking, and community action planning events. They included participation from targeted federal, state, local, nonprofit/philanthropic, and private sector leaders who are directly involved in decision making during a major community or state-wide emergency. A total of 4,971 government, nonprofit, and business leaders attended Meta-Leadership Summits; distribution of attendees by sector was balanced. Ninety-three percent of respondents reported the summit was a valuable use of time, 91% reported the overall quality as "good" or "outstanding," and 91% would recommend the summit to their colleagues. In addition, approximately 6 months after attending a summit, 80% of respondents reported that they had used meta-leadership concepts or principles. Of these, 93% reported that using meta-leadership concepts or principles had made a positive difference for them and their organizations. The Meta-Leadership Summit for Preparedness Initiative was a value-added opportunity for communities, providing the venue for learning the concepts and practice of meta-leadership, multisector collaboration, and resource sharing with the intent of substantively improving preparedness, response, and recovery efforts. PMID:24251597

Little is known about nurses' direct experiences of ethical preparedness for dealing with catastrophic publichealth emergencies and healthcare disasters or the ethical quandaries that may arise during such events. A systematic literature review was undertaken to explore and synthesize qualitative research literature reporting nurses' direct experiences of being prepared for and managing the ethical challenges posed by catastrophic publichealth emergencies and healthcare disasters. Twenty-six research studies were retrieved for detailed examination and assessed by two independent reviewers for methodological validity prior to inclusion in the review. Of these, 12 studies published between 1973 and 2011 were deemed to meet the inclusion criteria and were critically appraised. The review confirmed there is a significant gap in the literature on nurses' experiences of ethical preparedness for managing publichealth emergencies and healthcare disasters, and the ethical quandaries they encounter during such events. This finding highlights the need for ethical considerations in emergency planning, preparedness, and response by nurses to be given more focused attention in the interests of better informing the ethical basis of emergency disaster management. PMID:24635901

Background Due to the uncommon nature of large-scale disasters and emergencies, publichealth practitioners often turn to simulated emergencies, known as “exercises”, for preparedness assessment and improvement. Under the right conditions, exercises can also be used to conduct original publichealth systems research. This paper describes the integration of a research framework into a statewide operations-based exercise program in California as a systems-based approach for studying publichealth emergency preparedness and response. Methods We developed a research framework based on the premise that operations-based exercises conducted by medical and publichealth agencies can be described using epidemiologic concepts. Using this framework, we conducted a survey of key local and regional medical and health agencies throughout California following the 2010 Statewide Medical and Health Exercise. The survey evaluated: (1) the emergency preparedness capabilities activated and functions performed in response to the emergency scenario, and (2) the major challenges to inter-organizational communications and information management. Results Thirty-five local health departments (LHDs), 24 local emergency medical services (EMS) agencies, 121 hospitals, and 5 Regional Disaster Medical and Health Coordinators/Specialists (RDMHC) responded to our survey, representing 57%, 77%, 26% and 83%, respectively, of target agencies in California. We found two sets of response capabilities were activated during the 2010 Statewide Exercise: a set of core capabilities that were common across all agencies, and a set of agency-specific capabilities that were more common among certain agency types. With respect to one response capability in particular, inter-organizational information sharing, we found that the majority of respondents’ comments were related to the complete or partial failure of communications equipment or systems. Conclusions Using the 2010 Statewide Exercise in California

Global climate change will increase the probability of extreme weather events, including heatwaves, drought, wildfire, cyclones, and heavy precipitation that could cause floods and landslides. Such events create significant publichealth needs that can exceed local capacity to respond, resulting in excess morbidity or mortality and in the declaration of disasters. Human vulnerability to any disaster is a complex phenomenon with social, economic, health, and cultural dimensions. Vulnerability to natural disasters has two sides: the degree of exposure to dangerous hazards (susceptibility) and the capacity to cope with or recover from disaster consequences (resilience). Vulnerability reduction programs reduce susceptibility and increase resilience. Susceptibility to disasters is reduced largely by prevention and mitigation of emergencies. Emergency preparedness and response and recovery activities--including those that address climate change--increase disaster resilience. Because adaptation must occur at the community level, local publichealth agencies are uniquely placed to build human resilience to climate-related disasters. This article discusses the role of publichealth in reducing human vulnerability to climate change within the context of select examples for emergency preparedness and response. PMID:18929977

The Association of State and Territorial Directors of Nursing vision for emergency preparedness is that every community, family, and individual will have a comprehensive emergency preparedness plan that minimizes the consequences of disasters and emergencies, and enables communities, families, and individuals to respond and recover. This position paper provides national and state policy guidance during emergencies to all publichealth nurses in the United States and its Territories. Publichealth nurses bring critical experience to each phase of a disaster: mitigation, preparedness, response, and recovery. Publichealth nurses strive to achieve individual competencies so that they may better collaborate with others and contribute to emergency preparedness and response. Twelve Emergency Preparedness Competencies are listed in this position paper that will assist publichealth nurses with disaster prevention, planning, response, recovery, drills, exercises, and training. This position paper will be useful in clarifying the expertise that publichealth nurses can contribute to teams that serve to protect the health and safety of communities against disaster threats and realities. PMID:18666941

In order to maintain a strong front against both terrorist and natural threats, it is incumbent upon the publichealth system to employ workers who possess the skills and knowledge required to protect the health of the nation. The aim of this study is to contribute to an understanding of the learning needs of the publichealth workforce as the…

Pregnant and postpartum women have special needs during publichealth emergencies but often have inadequate levels of disaster preparedness. Thus, improving maternal emergency preparedness is a publichealth priority. More research is needed to identify the strengths and weaknesses of various approaches to how preparedness information is communicated to these women. A sample of web pages from the Centers for Disease Control and Prevention intended to address the preparedness needs of pregnant and postpartum populations was examined for suitability for this audience. Five of the 7 web pages examined were considered adequate. One web page was considered not suitable and one the raters split between not suitable and adequate. None of the resources examined were considered superior. If these resources are considered some of the best available to pregnant and postpartum women, more work is needed to improve the suitability of educational resources, especially for audiences with low literacy and low incomes. PMID:25882119

While climate change is inherently a global problem, its publichealth impacts will be experienced most acutely at the local and regional level, with some jurisdictions likely to be more burdened than others. The publichealth infrastructure in the U.S. is organized largely as an interlocking set of public agencies at the federal, state and local level, with lead responsibility for each city or county often residing at the local level. To understand how directors of local publichealth departments view and are responding to climate change as a publichealth issue, we conducted a telephone survey with 133 randomly selected local health department directors, representing a 61% response rate. A majority of respondents perceived climate change to be a problem in their jurisdiction, a problem they viewed as likely to become more common or severe over the next 20 years. Only a small minority of respondents, however, had yet made climate change adaptation or prevention a top priority for their health department. This discrepancy between problem recognition and programmatic responses may be due, in part, to several factors: most respondents felt personnel in their health department--and other key stakeholders in their community--had a lack of knowledge about climate change; relatively few respondents felt their own health department, their state health department, or the Centers for Disease Control and Prevention had the necessary expertise to help them create an effective mitigation or adaptation plan for their jurisdiction; and most respondents felt that their health department needed additional funding, staff and staff training to respond effectively to climate change. These data make clear that climate change adaptation and prevention are not currently major activities at most health departments, and that most, if not all, local health departments will require assistance in making this transition. We conclude by making the case that, through their words and actions

The Food and Drug Administration (FDA) is issuing a final regulation that requires the submission to FDA of prior notice of food, including animal feed, that is imported or offered for import into the United States. The final rule implements the PublicHealth Security and Bioterrorism Preparedness and Response Act of 2002 (the Bioterrorism Act), which required prior notification of imported food to begin on December 12, 2003. The final rule requires that the prior notice be submitted to FDA electronically via either the U.S. Customs and Border Protection (CBP or Customs) Automated Broker Interface (ABI) of the Automated Commercial System (ACS) or the FDA Prior Notice System Interface (FDA PNSI). The information must be submitted and confirmed electronically as facially complete by FDA for review no less than 8 hours (for food arriving by water), 4 hours (for food arriving by air or land/rail), and 2 hours (for food arriving by land/road) before the food arrives at the port of arrival. Food imported or offered for import without adequate prior notice is subject to refusal and, if refused, must be held. Elsewhere in this issue of the Federal Register, FDA is announcing the availability of a draft compliance policy guide (CPG) entitled "Sec. 110.310 Prior Notice of Imported Food Under the PublicHealth Security and Bioterrorism Preparedness and Response Act of 2002." PMID:19112701

The Food and Drug Administration (FDA) is issuing a final regulation that confirms the interim final rule entitled "Registration of Food Facilities Under the PublicHealth Security and Bioterrorism Preparedness and Response Act of 2002" (68 FR 58894, October 10, 2003 (interim final rule) as corrected by a technical amendment (69 FR 29428, May 24, 2004), and responds to comments submitted in response to the request for comments in the interim final rule. This final rule affirms the interim final rule's requirement that domestic and foreign facilities that manufacture/process, pack, or hold food for human or animal consumption in the United States be registered with FDA by December 12, 2003. The interim final rule implemented the PublicHealth Security and Bioterrorism Preparedness and Response Act of 2002 (the Bioterrorism Act), which requires domestic and foreign facilities to be registered with FDA by December 12, 2003. This final rule does not make any changes to the regulatory requirements established by the interim final rule. PMID:16200686

Hospital restructuring policies and an impending nursing workforce shortage have threatened the nation’s emergency preparedness. Current emergency response plans rely on sources of nurses that are limited and overestimated. A national investment in nursing education and workforce infrastructure, as well as incentives for hospitals to efficiently maximize nurse staffing, are needed to ensure emergency preparedness in the United States. This review highlights the challenges of maintaining hospital nursing surge capacity and policy implications of a nursing shortage. PMID:20840714

Introduction West Africa is experiencing the largest ever reported Ebola outbreak. Over 20,000 people have been infected of which about 9000 have died. It is possible that lack of community understanding of the epidemic and lack of institutional memory and inexperienced health workers could have led to the rapid spread of the disease. In this paper, we share Uganda's experiences on how the capacity of health workers and other multidisciplinary teams can be improved in preparing and responding to Ebola outbreaks. Methods Makerere University School of PublicHealth in collaboration with the Ministry of Health and the African Field Epidemiology Network (AFENET), trained health care workers and other multidisciplinary teams from six border districts of Uganda so as to increase their alertness and response capabilities towards Ebola. We used participatory training methods to impart knowledge and skills and guided participants to develop district epidemic response plans. Communities were sensitized about Ebola through mass media, IEC materials, and infection control and prevention materials were distributed in districts. Results We trained 210 health workers and 120 other multidisciplinary team members on Ebola surveillance, preparedness and response. Evaluation results demonstrated a gain in knowledge and skills. Communities were sensitized about Ebola and Districts received person protective equipments and items for infection prevention. Epidemic Preparedness and Response plans were also developed. Conclusion Training of multidisciplinary teams improves the country's preparedness, alertness and response capabilities in controlling Ebola. West African countries experiencing Ebola outbreaks could draw lessons from the Uganda experience to contain the outbreak. PMID:26301008

Emergencies such as hurricanes, floods and nuclear disasters do not just affect people and the environment; they also affect domestic animals. In this latest article in Veterinary Record's One Health series, Kendra Stauffer and Lisa Conti discuss how One Health considerations are being incorporated into emergency preparedness planning in the USA. PMID:25359746

Recent publichealth emergencies including Hurricane Katrina (2005), the influenza H1N1 pandemic (2009), and the Ebola virus disease outbreak in West Africa (2014–2015) have demonstrated the importance of multiple-level emergency planning and response. An effective response requires integrating coordinated contributions from community-based health care providers, regional health care coalitions, state and local health departments, and federal agency initiatives. This is especially important when planning for the needs of children, who make up 23% of the U.S. population (1) and have unique needs that require unique planning strategies. PMID:26356838

The 2010 World Exposition in Shanghai China (Expo) was the largest mass gathering in world history, attracting a record 72 million visitors. More than 190 countries participated in the Expo, along with more than 50 international organizations. The 2010 Expo was six months in duration (May 1 through October 30, 2010), and the size of the venue site comprised 5.28 square kilometers. Great challenges were imposed on the publichealth system in Shanghai due to the high number and density of visitors, long duration of the event, and other risk factors such as high temperatures, typhoon, etc. As the major metropolitan publichealth agency in Shanghai, the Shanghai Municipal Center for Disease Control and Prevention (SCDC) implemented a series of actions in preparing for, and responding to, the potential health impact of the world's largest mass gathering to date, which included partnerships for capacity building, enhancement of internal organizational structure, risk assessment, strengthened surveillance, disaster planning and exercises, laboratory management, vaccination campaign, health education, health intervention, risk communication and mass media surveillance, and technical support for health inspection. The clear-cut organizational structures and job responsibilities, as well as comprehensive operational and scientific preparations, were key elements to ensure the success of the 2010 World Exposition. PMID:22995587

The experience of federal health authorities in responding to the mailed anthrax attacks in the Fall of 2001 sheds light on the challenges of public information dissemination in emergencies. Lessons learned from the Fall of 2001 have guided more recent efforts related to crisis communication and preparedness goals. This article applies theories and evidence from the field of communication to provide an orientation to how publichealth communication can best contribute to the preparedness effort. This theoretical orientation provides a framework to systematically assess current recommendations for preparedness communication. PMID:15596970

Although communicable diseases have hitherto played a small part in illness associated with Olympic Games, an outbreak of infection in a national team, Games venue or visiting spectators has the potential to disrupt a global sporting event and distract from the international celebration of athletic excellence. Preparation for hosting the Olympic Games includes implementation of early warning systems for detecting emerging infection problems. Ensuring capability for rapid microbiological diagnoses to inform situational risk assessments underpins the ability to dispel rumours. These are a prelude to control measures to minimize impact of any outbreak of infectious disease at a time of intense public scrutiny. Complex multidisciplinary teamwork combined with laboratory technical innovation and efficient information flows underlie the Health Protection Agency's preparation for the London 2012 Olympic and Paralympic Games. These will deliver durable legacies for clinical and publichealth microbiology, outbreak investigation and control in the coming years. PMID:22892344

State health policy for terrorism preparedness began before the terrorist attacks on September 11, 2001, but was accelerated after that day. In a crisis atmosphere after September 11, the states found their policies changing rapidly, greatly influenced by federal policies and federal dollars. In the 5 years since September 11, these state health policies have been refined. This refinement has included a restatement of the goals and objectives of state programs, the modernization of emergency powers statutes, the education and training of the publichealth workforce, and a preparation of the health care system to better care for victims of disasters, including acts of terrorism. PMID:17666689

Our objective was to inform state and community interventions focused on increasing household preparedness by examining the association between self-reported possession of household disaster preparedness items (ie, a 3-day supply of food and water, a written evacuation plan, and a working radio and flashlight) and perceptions of household preparedness on a 3-point scale from "well prepared" to "not at all prepared." Data were analyzed from 14 states participating in a large state-based telephone survey: the 2006-2010 Behavioral Risk Factor Surveillance System (BRFSS) (n = 104,654). Only 25.3% of the population felt they were well prepared, and only 12.3% had all 5 of the recommended items. Fewer than half the households surveyed had 4 or more of the recommended preparedness items (34.1%). Respondents were more likely to report their households were well prepared as the number of preparedness items possessed by their household increased. Risk factors for having no preparedness items were: younger age, being female, lower levels of education, and requesting the survey to be conducted in Spanish. To increase household disaster preparedness, more community-based preparedness education campaigns targeting vulnerable populations, such as those with limited English abilities and lower reading levels, are needed. PMID:26348094

... Proposed Rulemaking (75 FR 42363) should be marked ``Comments on the changes to the list of select agents... Register (75 FR 42363) requesting public comment on the current HHS list of select agents and toxins. The... Register (75 FR 44724) requesting public comment on the USDA/APHIS list of select agents and toxins....

... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Public Readiness and Emergency Preparedness... CICP administers the compensation program authorized by the Public Readiness and Emergency...

The importance of health security in the United States has been highlighted by recent emergencies such as the H1N1 influenza pandemic, Superstorm Sandy, and the Boston Marathon bombing. The nation's health security remains a high priority today, with federal, state, territorial, tribal, and local governments, as well as nongovernment organizations and the private sector, engaging in activities that prevent, protect, mitigate, respond to, and recover from health threats. The Association of State and Territorial Health Officials (ASTHO), through a cooperative agreement with the Centers for Disease Control and Prevention (CDC) Office of PublicHealthPreparedness and Response (OPHPR), led an effort to create an annual measure of health security preparedness at the national level. The collaborative released the National Health Security Preparedness Index (NHSPI(™)) in December 2013 and provided composite results for the 50 states and for the nation as a whole. The Index results represent current levels of health security preparedness in a consistent format and provide actionable information to drive decision making for continuous improvement of the nation's health security. The overall 2013 National Index result was 7.2 on the reported base-10 scale, with areas of greater strength in the domains of health surveillance, incident and information management, and countermeasure management. The strength of the Index relies on the interdependencies of the many elements in health security preparedness, making the sum greater than its parts. Moving forward, additional health security-related disciplines and measures will be included alongside continued validation efforts. PMID:24896305

Natural disasters, infectious disease epidemics, terrorism, and major events like the nuclear incident at Fukushima all pose major potential challenges to publichealth and security. Events such as the anthrax letters of 2001, Hurricanes Katrina, Irene, and Sandy, severe acute respiratory syndrome (SARS) and West Nile virus outbreaks, and the 2009 H1N1 influenza pandemic have demonstrated that publichealth, emergency management, and national security efforts are interconnected. These and other events have increased the national resolve and the resources committed to improving the national health security infrastructure. However, as fiscal pressures force federal, state, and local governments to examine spending, there is a growing need to demonstrate both what the investment in publichealthpreparedness has bought and where gaps remain in our nation's health security. To address these needs, the Association of State and Territorial Health Officials (ASTHO), through a cooperative agreement with the Centers for Disease Control and Prevention (CDC) Office of PublicHealthPreparedness and Response (PHPR), is creating an annual measure of health security and preparedness at the national and state levels: the National Health Security Preparedness Index (NHSPI). PMID:23506403

Background This study examined the association between self-reported levels of household disaster preparedness and a range of physical and mental health quality of life outcomes. Methods Data collected from 14 states participating in a large state-based telephone survey were analyzed (n 5 104 654). Household disaster-preparedness items included having a 3-day supply of food, water, and prescription medications; a working battery-powered radio and flashlight; an evacuation plan; and a willingness to evacuate when instructed to do so. Quality-of-life items were categorized into 2 domains: physical health (general health, unhealthy physical days, and activity-limited days) and mental health (unhealthy mental days, social and emotional support, and life satisfaction). Results Persons with self-reported impaired mental health were generally less likely to report being prepared for a disaster than those who did not report impairment in each domain. Persons with low life satisfaction were among the least likely to be prepared, followed by those with inadequate social and emotional support, and then by those with frequent mental distress. Persons reporting physical impairments also reported deficits in many of the preparedness items. However, after adjusting for sociodemographic characteristics, some of the associations were attenuated and no longer significant Conclusion Persons reporting impaired quality of life are vulnerable to increased mental and physical distress during a disaster, and their vulnerability is compounded if they are ill-prepared. Therefore, persons reporting impaired quality of life should be included in the list of vulnerable populations that need disaster preparedness and response outreach. PMID:24618171

Objectives We examined the association between housing type and household emergency preparedness among households in Oakland County, Michigan. Methods We used interview data on household emergency preparedness from a cluster design survey in Oakland County, Michigan, in 2012. We compared survey-weighted frequencies of household demographics, medical conditions, and preparedness measures in single-detached homes versus multi-unit dwellings, and determined the unadjusted odds ratios (OR) and the income-level adjusted OR for each preparedness measure. Results Households had similar demographics and medical conditions between housing types. Unadjusted ORs were statistically significant for single-detached homes having a generator (11.1), back-up heat source (10.9), way to cook without utilities (5.8), carbon monoxide (CO) detector (3.8), copies of important documents (3.4), evacuation routes (3.1), and three-day supply of water (2.5). Income level adjusted ORs remained statistically significant except for owning a CO detector. Conclusions Households in multi-unit dwellings were less likely to have certain recommended emergency plans and supplies compared to those in single-detached homes. Further research is required to explore the feasibility, barriers, and alternatives for households in multi-unit dwellings in terms of complying with these measures. PMID:24524350

In this article, evidence that health sector preparedness improves response performance in disasters was examined. Case fatality and survival data were compared for four earthquakes, in relation to health sector emergency preparedness levels. Vast differences in performance were found. The two California systems, with a high preparedness index, had low case fatality rates (about one death per 100 injuries). Kobe, Japan, with mixed levels of preparedness, had 31 deaths per 100 injuries, and Armenia (low preparedness index) had 167. Publichealth and health sector preparedness made a significant difference in the ability to respond effectively to meet patient needs in disasters, although it is only one of several factors that determine the health outcome of disaster victims. PMID:15596966

Mass gatherings at major international sporting events put millions of international travelers and local host-country residents at risk of acquiring infectious diseases, including locally endemic infectious diseases. The mosquito-borne Zika virus (ZIKV) has recently aroused global attention due to its rapid spread since its first detection in May 2015 in Brazil to 22 other countries and other territories in the Americas. The ZIKV outbreak in Brazil, has also been associated with a significant rise in the number of babies born with microcephaly and neurological disorders, and has been declared a 'Global Emergency by the World Health Organization. This explosive spread of ZIKV in Brazil poses challenges for publichealthpreparedness and surveillance for the Olympics and Paralympics which are due to be held in Rio De Janeiro in August, 2016. We review the epidemiology and clinical features of the current ZIKV outbreak in Brazil, highlight knowledge gaps, and review the publichealth implications of the current ZIKV outbreak in the Americas. We highlight the urgent need for a coordinated collaborative response for prevention and spread of infectious diseases with epidemic potential at mass gatherings events. PMID:26854199

Specific issues relevant to the emergency healthpreparedness of schools and the key roles and expectations applicable to teachers are outlined. It is noted that, while issues of legal liability relevant to teachers are complex, teachers are expected to: (1) anticipate possible risk or harm involved in activities; (2) give adequate warning of…

The Global Health Security Agenda's objectives contain components that could help health departments address emerging publichealth challenges that threaten the population. As part of the agenda, partner countries with advanced publichealth systems will support the development of infrastructure in stakeholder health departments. To facilitate this process and augment local programs, state and local health departments may want to include concepts of health security in their publichealthpreparedness offices in order to simultaneously build capacity. Health security programs developed by publichealth departments should complete projects that are closely aligned with the objectives outlined in the global agenda and that facilitate the completion of current preparedness grant requirements. This article identifies objectives and proposes tactical local projects that run parallel to the 9 primary objectives of the Global Health Security Agenda. Executing concurrent projects at the international and local levels in preparedness offices will accelerate the completion of these objectives and help prevent disease epidemics, detect health threats, and respond to publichealth emergencies. Additionally, future funding tied or related to health security may become more accessible to state and local health departments that have achieved these objectives. PMID:25396695

To improve mental health care in Nepal, a National Mental Health Policy, Strategy and Plan of Action was approved by the Government in 1997. Nepal has high vulnerability to natural disasters compounded by a prolonged violent civil conflict affecting almost all districts of the country. Floods, landslides and earthquakes are the most regularly occurring disasters in Nepal. There is a Health Sector Emergency and Disaster Response Plan of the Ministry of Health, but mental health and psychosocial relief is not adequately addressed in this plan. In 2003 guidelines on best publichealth practices in emergencies for district health workers was developed in which the minimum standard and indicators include aspects of mental and social aspects of health. The experience of the complex emergency in April 2005 showed that in general the emergency preparedness plan has not been prepared well enough, but on the other hand the health system was able to cope quite well because of past training. Further strengthening of the mental health and psychosocial aspects of disaster preparedness is strongly recommended. PMID:17162702

Objectives Faculty and affiliates of the Johns Hopkins Preparedness and Emergency Response Research Center partnered with local health departments and faith-based organizations to develop a dual-intervention model of capacity-building for public mental healthpreparedness and community resilience. Project objectives included (1) determining the feasibility of the tri-partite collaborative concept; (2) designing, delivering, and evaluating psychological first aid (PFA) training and guided preparedness planning (GPP); and (3) documenting preliminary evidence of the sustainability and impact of the model. Methods We evaluated intervention effectiveness by analyzing pre- and post-training changes in participant responses on knowledge-acquisition tests administered to three urban and four rural community cohorts. Changes in percent of correct items and mean total correct items were evaluated. Criteria for model sustainability and impact were, respectively, observations of nonacademic partners engaging in efforts to advance post-project preparedness alliances, and project-attributable changes in preparedness-related practices of local or state governments. Results The majority (11 of 14) test items addressing technical or practical PFA content showed significant improvement; we observed comparable testing results for GPP training. Government and faith partners developed ideas and tools for sustaining preparedness activities, and numerous project-driven changes in local and state government policies were documented. Conclusions Results suggest that the model could be an effective approach to promoting publichealthpreparedness and community resilience. PMID:25355980

Objective 1. To conduct a review of the role of informatics in pediatric disaster preparedness using all medical databases. 2. To provide recommendations to improve pediatric disaster preparedness by the application of informatics. Methods A literature search was conducted using MEDLINE, CINHL and the Cochrane Library using the key words “children” AND “disaster preparedness and disaster” AND “informatics”. Results A total of 314 papers were initially produced by the search and eight that met the selection criteria were included in the review. Four themes emerged: tools for disaster preparedness, education, reunification and planning and response. Conclusion The literature pertaining to informatics and pediatric disaster preparedness is sparse and many gaps still persist. Current disaster preparedness tools focus on the general population and do not specifically address children. The most progress has been achieved in family reunification; however, the recommendations delineated are yet to be completed. PMID:23616840

Hazardous and noxious chemicals are increasingly being transported by sea. Current estimates indicate some 2000 hazardous and noxious substances (HNS) are carried regularly by sea with bulk trade of 165milliontonnes per year worldwide. Over 100 incidents involving HNS have been reported in EU waters. Incidents occurring in a port or coastal area can have potential and actual publichealth implications. A methodology has been developed for prioritisation of HNS, based upon potential publichealth risks. The work, undertaken for the Atlantic Region Pollution Response programme (ARCOPOL), aims to provide information for incident planning and preparedness. HNS were assessed using conventional methodology based upon acute toxicity, behaviour and reactivity. Tonnage was used as a proxy for likelihood, although other factors such as shipping frequency and local navigation may also contribute. Analysis of 350 individual HNS identified the highest priority HNS as being those that present an inhalation risk. Limitations were identified around obtaining accurate data on HNS handled on a local and regional level due to a lack of port records and also political and commercial confidentiality issues. To account for this the project also developed a software tool capable of combining chemical data from the study with user defined shipping data to be used by operators to produce area-specific prioritisations. In conclusion a risk prioritisation matrix has been developed to assess the acute risks to publichealth from the transportation of HNS. Its potential use in emergency planning and preparedness is discussed. PMID:24953645

We describe the collaborative approach used by 2 health systems in Wisconsin to plan and prepare for the threat of Ebola virus disease. This was a descriptive study of the preparedness planning, infection prevention, and collaboration with publichealth agencies undertaken by 2 health systems in Wisconsin between September and December 2014. The preparedness approach used by the 2 health systems relied successfully on their robust infrastructure for planning and infection prevention. In the setting of rapidly evolving guidance and unprecedented fear regarding Ebola, the 2 health systems enhanced their response through collaboration and coordination with each other and government publichealth agencies. Key lessons learned included the importance of a rigorous planning process, robust infection prevention practices, and coalitions between public and private health sectors. The potential threat of Ebola virus disease stimulated emergency preparedness in which acute care facilities played a leading role in the publichealth response. Leveraging the existing expertise of health systems is essential when faced with emerging infectious diseases. (Disaster Med PublicHealthPreparedness. 2016;10:691-697). PMID:26370206

Ever since the terrorist attacks of 9/11, the federal government increased funding for emergency preparedness. However, the literature continues to document several areas of weaknesses in publichealth emergency management by local health departments (LHD). This literature review discusses the role of information technology (IT) for emergency preparedness by LHDs. The focus areas for this review include evaluating the strategic management of IT by LHD, evaluation of the adoption and implementation of IT in emergency management, and assessing LHD's capacity and capability for emergency preparedness. Findings reveal that LHDs face significant challenges in the utilization of IT for emergency preparedness purposes such as weak capacity and capabilities, lack of structured planning and program implementation, and limited resources. Implications from this review include the development of "best practices," increased funding for IT infrastructure, and the establishment of strategic management framework for IT initiatives. PMID:25069026

This report describes how, in the aftermath of Hurricane Hugo, the South Carolina Department of Mental Health activated its Emergency Preparedness Plan to assist mental health centers and their staff in providing crisis counseling services to the general public. The first section explains the history and structure of the involvement by the…

The close interplay between mental health and physical health makes it critical to integrate mental and behavioral health considerations into all aspects of publichealth and medical disaster management. Therefore, the National Biodefense Science Board (NBSB) convened the Disaster Mental Health Subcommittee to assess the progress of the US Department of Health and Human Services (HHS) in integrating mental and behavioral health into disaster and emergency preparedness and response activities. One vital opportunity to improve integration is the development of clear and directive national policy to firmly establish the role of mental and behavioral health as part of a unified publichealth and medical response to disasters. Integration of mental and behavioral health into disaster preparedness, response, and recovery requires it to be incorporated in assessments and services, addressed in education and training, and founded on and advanced through research. Integration must be supported in underlying policies and administration with clear lines of responsibility for formulating and implementing policy and practice. PMID:22490938

Objective We tested the Analytical Hierarchy Process tool for its use in publichealth to identify potential gaps in emergency preparedness by local health departments (LHDs) in California and Hawaii during a radiological emergency. Methods We developed a dedicated tool called All-Hazards Preparedness Squared (AHP2) that can be used by those who are responsible for all-hazards preparedness planning and response to guide them while making strategic decisions both in preparing for and responding to a slow-moving incident while it is unfolding. The tool is an Internet-based survey that can be distributed among teams responsible for emergency preparedness and response. Twenty-eight participants from 16 LHDs in California and Hawaii responsible for coordinating preparedness and response in a radiological emergency participated in using the tool in 2013. We used the data to compare the perceived importance of different elements of preparedness among participants and identify gaps in preparedness of their organizations for meeting the challenges presented by a radiological incident. Results Clarity of information and transfer of information (to and from agency to public, state, and federal partners) were publichealth officials' dominant concerns while responding to an emergency. Participants also found that there were gaps in the adequacy of training and awareness of the chain of command during a radiological emergency. Conclusion This preliminary study indicates that the AHP2 tool could be used for decision making in all-hazards preparedness planning and response. PMID:25355985

The South Carolina Area Health Education Consortium (SC AHEC) was funded in 2003 to train healthcare professionals in disaster preparedness and response. During the 5 years of funding, its Disaster Preparedness and Response Training Network evolved from disaster awareness training to competency-based instruction and performance assessment. With funding from the assistant secretary for preparedness and response (ASPR), a project with implications for national dissemination was developed to evaluate 2 aspects of preparedness training for community-based healthcare professionals. The SC AHEC designed disaster preparedness curricula and lesson plans, using a consensus-building technique, and then (1) distributed sample curricula and resources through the national Area Health Education Center system to assess an approach for providing preparedness training and (2) delivered a standardized preparedness curriculum to key influential thought leaders from 4 states to evaluate the effectiveness and acceptability of the curriculum. As a result of this project, the SC AHEC recommends that preparedness training for community-based practitioners needs to be concise and professionally relevant. It should be integrated into existing healthcare professions education programs and continuing education offerings. The project also demonstrated that although AHECs may be interested and well suited to incorporate preparedness training as part of their mission, more work needs to be done if they are to assume a prominent role in disaster preparedness training. PMID:19202395

Ever since the terrorist attacks of 9/11, the federal government has increased funding for emergency preparedness. However, the literature continues to document several areas of weaknesses in publichealth emergency management by local health departments (LHD). This lack of preparedness affects the entire public. The purpose of this study was to determine whether or not Maryland LHDs have effectively put in place the information technology (IT) that is relevant for emergency preparedness. Base Firm-wide IT Infrastructure Services and the Feeny/Willcocks Framework for Core IS Capabilities are the two conceptual frameworks used in this study. This qualitative study used the survey method and the data were analyzed through content analysis. The results revealed that utilization, practice, and performance of IT by Maryland LHDs are not efficient or effective. Recommendations included the development of "best practices," increased funding for IT infrastructure and the establishment of strategic management framework for IT initiatives. Implications for positive social change include the development of recommendations to enhance emergency preparedness practice, and advancement of knowledge so as to facilitate the functions, and duties of health departments in emergency preparedness operations. PMID:24187746

Whilst healthcare is the biggest service industry on the globe, it has yet to realise the full potential of the e-business revolution in the form of e-health. This is due to many reasons including the fact that the healthcare industry is faced with many complex challenges in trying to deliver cost-effective, high-value, accessible healthcare and has traditionally been slow to embrace new business techniques and technologies. Given that e-health, to a great extent, is a macro level concern that has far reaching micro level implications, this paper firstly develops a framework to assess a country's preparedness with respect to embracing e-health (the application of e-commerce to healthcare) and from this an e-healthpreparedness grid to facilitate the assessment of any e-health initiative. Taken together, the integrative framework and preparedness grid provide useful and necessary tools to enable successful e-health initiatives to ensue by helping country and/or an organisation within a country to identify and thus address areas that require further attention in order for it to undertake a successful e-health initiative. PMID:18048213

The United States faces serious publichealth threats from the deliberate use of weapons of mass destruction (WMD)--chemical, biological, radiological, or nuclear (CBRN)--by hostile States or terrorists, and from naturally emerging infectious diseases that have a potential to cause illness on a scale that could adversely impact national security. Effective strategies to prevent, mitigate, and treat the consequences of CBRN threats is an integral component of our national security strategy. To that end, the United States must be able to rapidly develop, stockpile, and deploy effective medical countermeasures to protect the American people. The HHS PublicHealth Emergency Medical Countermeasures Enterprise (PHEMCE) has taken a holistic, end-to-end approach that considers multiple aspects of the medical countermeasures mission including research, development, acquisition, storage, maintenance, deployment, and guidance for utilization. Phase one of this approach established the HHS PHEMCE Strategy for Chemical, Biological, Radiological, and Nuclear Threats (HHS PHEMCE Strategy). The HHS PHEMCE Strategy, published in the Federal Register on March 20, 2007, described a framework of strategic policy goals and objectives for identifying medical countermeasure requirements and establishing priorities for medical countermeasure evaluation, development and acquisition. These strategic policy goals and objectives were used to establish the Four Pillars upon which this HHS PublicHealth Emergency Medical Countermeasures Enterprise Implementation Plan (HHS PHEMCE Implementation Plan) is based. The HHS PHEMCE Implementation Plan considers the full spectrum of medical countermeasures-related activities, including research, development, acquisition, storage/maintenance, deployment, and utilization. The HHS PHEMCE Implementation Plan is consistent with the President's Biodefense for the 21st Century and is aligned with the National Strategy for Medical Countermeasures against

Community awareness, preparedness and response to publichealth emergencies are essential for a successful response to publichealth emergencies. This study was carried out to determine community awareness and perceptions regarding health sector preparedness and response to Cyclone Nargis in Myanmar. Six focus group discussions were carried out in 3 villages severely affected by Cyclone Nargis. Thematic content analysis was carried out to determine community perceptions. Focus group participants, consisting of community members, community leaders and government personnel, were aware of the cyclone, but were unaware of its intensity and where it would make landfall. There was inadequate knowledge on how to prepare for a cyclone. There was some training on cyclone preparation but coverage was not wide enough. Participants received service and relief from health sector; they had a positive attitude toward health services provided to them. However, 5 out of 6 focus groups stated most villagers were not interested in health education. Only a few participants had some knowledge on how to prepare for a cyclone. Based on these results, there are evident weaknesses on how to prepare for cyclones. Community preparedness is essential to prevent disasters with cyclones, such as with Cyclone Nargis. PMID:22299485

The strengthening of health systems is fundamental to improving health outcomes, crisis preparedness, and our capacity to meet global challenges, such as accelerating progress towards the Millennium Development Goals, reducing maternal and child mortality, combating HIV, malaria and other diseases, limiting the effects of a new influenza pandemic, and responding appropriately to climate change. To meet these complex needs, the Association of Schools and Programs in PublicHealth, the World Health Organization, and the Institute of Medicine promote systems thinking as the only sensible means to respond to issues that greatly exceed the normal capacity of health and medical services. This paper agrees with the application of systems thinking but argues that health organizations have misunderstood and misapplied systems thinking to the extent that the term has become meaningless. This paper presents the basic constructs of systems thinking, explains why systems thinking has been misapplied, examines some misapplications of systems thinking in health, and suggests how the concept can be applied correctly to medicine and publichealth to achieve the reason it was adopted in the first place. PMID:24377080

Disaster preparedness and response have gained increased attention in the United States as a result of terrorism and disaster threats. However, funding of hospital preparedness, especially surge capacity, has lagged behind other preparedness priorities. Only a small portion of the money allocated for national preparedness is directed toward health care, and hospitals receive very little of that. Under current policy, virtually the entire funding stream for hospital preparedness comes from general tax revenues. Medical payers (e.g., Medicare, Medicaid, and private insurance) directly fund little, if any, of the current bill. Funding options to improve preparedness include increasing the current federal grants allocated to hospitals, using payer fees or a tax to subsidize preparedness, and financing other forms of expansion capability, such as mobile hospitals. Alternatively, the status quo of marginal preparedness can be maintained. In any event, achieving higher levels of preparedness likely will take the combined commitment of the hospital industry, public and private payers, and federal, state, and local governments. Ultimately, the costs of preparedness will be borne by the public in the form of taxes, higher healthcare costs, or through the acceptance of greater risk. PMID:18087914

Emergency preparedness can be considered to be a form of lifelong learning and public pedagogy with implications for race equality. The paper is based on an ESRC project "Preparedness pedagogies and race: an interdisciplinary approach" considering the policy process around the construction of the "Preparing for Emergencies" (PFE) campaign. This…

Influenza pandemic planning is a complex, multifactorial process, which involves publichealth authorities, regulatory authorities, academia and industry. It is further complicated by the unpredictability of the time of emergence and severity of the next pandemic and the effectiveness of influenza epidemic interventions. The complexity and uncertainties surrounding pandemic preparedness have so far kept the various stakeholders from joining forces and tackling the problem from its roots. We developed a mathematical model, which shows the tangible consequences of conceptual plans by linking possible pandemic scenarios to health economic outcomes of possible intervention strategies. This model helps to structure the discussion on pandemic preparedness and facilitates the translation of pandemic planning concepts to concrete plans. The case study for which the model has been used shows the current level of global pandemic preparedness in an assumed pandemic scenario, the health economic implications of enhanced pandemic vaccine supply and the importance of cell culture-based influenza vaccine manufacturing technologies as a tool for pandemic control. PMID:15163482

Since 2001, our nations' leaders, the press, and the general public have looked to the health sector for leadership in addressing acts of terrorism. It has become urgent for health agencies and related public services to collaborate and for all health professionals to become knowledgeable about disaster preparedness. This article describes collaboration between the publichealth department, local hospitals and the school of nursing in one community, Charlottesville, Virginia, to address disaster preparedness. In this story about our community's emergency preparedness, the focus is both on preparation and the hope we will never need to utilize this knowledge. PMID:15596974

For the response to a zoonotic disease outbreak to be effective, animal health authorities and disease specialists must be involved. Animal health measures are commonly directed at known diseases that threaten the health of animals and impact owners. The measures have long been applied to zoonotic diseases, including tuberculosis and brucellosis, and can be applied to emerging diseases. One Health (veterinary, public, wildlife and environmental health) and all-hazards preparedness work have done much to aid interdisciplinary understanding and planning for zoonotic diseases, although further improvements are needed. Actions along the prevention, preparedness, response and recovery continuum should be considered. Prevention of outbreaks consists largely of import controls on animals and animal products and biosecurity. Preparedness includes situational awareness, research, tool acquisition, modelling, training and exercises, animal movement traceability and policy development. Response would include detection systems and specialized personnel, institutions, authorities, strategies, methods and tools, including movement control, depopulation and vaccination if available and appropriate. The specialized elements would be applied within a general (nationally standardized) system of response. Recovery steps begin with continuity of business measures during the response and are intended to restore pre-event conditions. The surveillance for novel influenza A viruses in swine and humans and the preparedness for and response to the recent influenza pandemic illustrate the cooperation possible between the animal and publichealth communities. PMID:22958252

The vast number of outbreaks of tension on the planet shows that it is impossible to underestimate the preparation level of population protection in emergencies. The possibility of a terrorist attack, including the use of particularly toxic or biological substances cannot be excluded or totally prevented at this point. In fact, there may not only be a terrorist attack. Rampant population migration increases the risk of the transmission of infectious diseases, even to considerable distances from the states where the epidemiological situation might not be completely under control. The current state of the Czech healthcare system in terms of preparedness for mass emergencies is insufficient and requires prompt correction, though not through hastily adopted measures. Ideally, looking into the success of the Israeli preparedness system, where the public has been exposed to high levels of threat from a variety of causes for decades, could greatly aid the Czech Republic in moving forward effectively. The number of victims of terrorist attacks there outpaces 10000, a fact that shows Israel is experienced in responding to emergency incidents. PMID:26311029

The PublicHealth application area focuses on Earth science applications to publichealth and safety, particularly regarding infectious disease, emergency preparedness and response, and environmental health issues. The application explores issues of toxic and pathogenic exposure, as well as natural and man-made hazards and their effects, for risk characterization/mitigation and improvements to health and safety.

The State Library of Ohio designed this disaster preparedness plan to assist small libraries in gathering information that will be invaluable in the event of an emergency. This plan, which focuses on fire and water disaster prevention, is devoted to using simple and inexpensive measures to prevent a disaster or to lessen its effect. The plan…

Introduction: Naturally occurring and man-made disasters have been increasing in the world, including Europe, over the past several decades. Health systems are a key part of any community disaster management system. The success of preparedness and prevention depends on the success of activities such as disaster planning, organization and training. The aim of this study is to evaluate health system preparedness for disasters in the 27 European Union member countries. Method: A cross-sectional analysis study was completed between June-September 2012. The checklist used for this survey was a modified from the World Health Organization toolkit for assessing health-system capacity for crisis management. Three specialists from each of the 27 European Union countries were included in the survey. Responses to each survey question were scored and the range of preparedness level was defined as 0-100%, categorized in three levels as follows: Acceptable; Transitional; or Insufficient. Results: Response rate was 79.1%. The average level of disaster management preparedness in the health systems of 27 European Union member states was 68% (Acceptable). The highest level of preparedness was seen in the United Kingdom, Luxemburg, and Lithuania. Considering the elements of disaster management system, the highest level of preparedness score was at health information elements (86%), and the lowest level was for hospitals, and educational elements (54%). Conclusion: This survey study suggests that preparedness level of European Union countries in 2012 is at an acceptable level but could be improved. Elements such as hospitals and education and training suffer from insufficient levels of preparedness. The European Union health systems need a collective strategic plan, as well as enough resources, to establish a comprehensive and standardized disaster management strategy plan. A competency based training curriculum for managers and first responders is basic to accomplishing this goal

Earth observations can be used to address human health concerns in many ways: projecting occurrence of disease or disease outbreaks; rapid detection and tracking of events; construction of risk maps; targeting interventions; and enhancing knowledge of human health-environment int...

At the intersection of online education and preparedness, Johns Hopkins University's (JHU) Center for PublicHealthPreparedness provides all-hazards preparedness and response training for publichealth and public safety professionals. This report comes from Jonathan Links' keynote address to the Sloan Summer Research Workshop in Baltimore,…

This study assesses schools' experiences with, and preparedness for, emergencies and disasters. Data are collected by mail survey from 157 public schools in California. The majority of schools have experienced emergencies in recent years. Although respondents generally feel their school is well prepared for future emergencies, limitations are…

The School Health Policies and Programs Study (SHPPS) is a national survey periodically conducted to assess school health policies and programs at the state, district, school, and classroom levels. This brief presents data on crisis preparedness, response, and recovery as it pertains to health services, mental health and social services, nutrition…

This study explored the experiences of 80 home health aides (HHAs) whose client died within the last two months. Data collection involved comprehensive semi-structured in-person interviews to try to better understand characteristics of HHAs and their clients associated with preparedness for death. Among those, personal end-of-life (EOL) care preferences of HHAs and having knowledge of preferences and decisions regarding client’s EOL care showed significant links to preparedness. Findings suggest that HHAs’ preparedness for client death could be enhanced both by addressing their personal views on EOL care and by providing more information about the client’s EOL care plans. PMID:26496432

Global health electives based in resource-poor countries have become extremely popular with medical students from resource rich ones. As the number of such programs and participants increase, so too do the absolute health and safety risks. It is clear from a number of published reports that many institutions provide little or no meaningful preparedness for students and do little to ensure their health and safety. These deficiencies together can affect students, their foreign hosts, and sponsoring institutions. The School of PublicHealth at the State University of New York, Downstate Medical Center, and its predecessor, the Department of Preventive Medicine and Community Health, have sponsored a 6-8 week global health elective for fourth year medical students since 1980. The purposes of this elective are to provide students with an opportunity to observe the health care and publichealth systems in resource-poor countries, provide medical service, and have a cross-cultural experience. Over the course of the past 35 years, 386 students have participated in this global health elective in more than 41 resource-poor countries. Recent annual applications for this elective have been as high as 44 out of a class of 200 students. Over the past 10 years, annual acceptance rates have varied, ranging from a low of 32 % in 2007-2008 to a high of 74 % in 2010-2011 and 2013-2014. Careful screening, including a written application, review of academic records and personal interviews, has resulted in the selection of highly mature, adaptable, and dedicated students who have performed well at overseas sites. Appropriately preparing students for an overseas global health experience in resource-poor countries requires the investment of much professional and staff time and effort. At the SUNY Downstate School of PublicHealth, these resources have underpinned our Global Health in Developing Countries elective for many years. As a result, the elective is characterized by meticulous

Twitter can serve as a powerful communication modality to both "push" and "pull" publichealth data; each user is a potential publichealth sensor and actor. However, in 2012, only 8% of local health departments had Twitter accounts. We outline how Twitter works, describe how to access public tweets for publichealth surveillance purposes, review the literature on Twitter's current and potential role supporting publichealth's essential services, summarize Twitter's limitations, and make recommendations for health department use. PMID:24356087

pandemic stages was limited. The interfaces and linkages between health system contexts and pandemic preparedness programmes in these countries were explored. Conclusion Health system context influences how the six countries have been preparing themselves for a pandemic. At the same time, investment in pandemic preparation in the six Asian countries has contributed to improvement in health system surveillance, laboratory capacity, monitoring and evaluation and public communications. A number of suggestions for improvement were presented to strengthen the pandemic preparation and mitigation as well as to overcome some of the underlying health system constraints. PMID:20529345

This chapter is a review of the current state of publichealth in light of the social, political, economic, scientific, and technological changes buffeting the United States. As an assessment of progress in current publichealth efforts, we address the five major issues in publichealth for the 1990s raised by Breslow (8): reconstruction of publichealth; setting objectives for publichealth; from disease control to health promotion; determinants of health and health policy; continuing social inequities and their impacts on health; and the health implications of accelerating developments in technology. Finally, we look to the twenty-first century and provide five clear paths necessary to strengthen the capacity of publichealth agencies to protect and improve the health status of the population. PMID:9143710

Federal publichealth advisors provide guidance and assistance to health departments to improve publichealth program work. The Centers for Disease Control and Prevention (CDC) prepares them with specialized training in administering publichealth programs. This article describes the evolving training and is based on internal CDC documents and interviews. The first federal publichealth advisors worked in health departments to assist with controlling syphilis after World War II. Over time, more CDC prevention programs hired them. To meet emerging needs, 3 major changes occurred: the PublicHealth Prevention Service, a fellowship program, in 1999; the PublicHealth Associate Program in 2007; and integration of those programs. Key components of the updated training are competency-based training, field experience, supervision, recruitment and retention, and stakeholder support. The enduring strength of the training has been the experience in a publichealth agency developing practical skills for program implementation and management. PMID:25564995

Federal publichealth advisors provide guidance and assistance to health departments to improve publichealth program work. The Centers for Disease Control and Prevention (CDC) prepares them with specialized training in administering publichealth programs. This article describes the evolving training and is based on internal CDC documents and interviews. The first federal publichealth advisors worked in health departments to assist with controlling syphilis after World War II. Over time, more CDC prevention programs hired them. To meet emerging needs, 3 major changes occurred: the PublicHealth Prevention Service, a fellowship program, in 1999; the PublicHealth Associate Program in 2007; and integration of those programs. Key components of the updated training are competency-based training, field experience, supervision, recruitment and retention, and stakeholder support. The enduring strength of the training has been the experience in a publichealth agency developing practical skills for program implementation and management. PMID:25564995

Public institutions such as governmental facilities, hospitals, universities, and amusement parks may be targeted by terrorists using weapons of mass destruction due to their potential to cause large numbers of casualties. Consequentially, these institutions should be prepared to manage such an event by the development and implementation of specific preparedness guidelines for any conventional or unconventional terrorist attacks. In order to test the preparedness of such an institution for a chemical event, a large-scale drill focusing on the first medical team to respond was conducted. Some important lessons regarding the way the medical team operates and communicates were learned from this drill. Periodic drills should be performed in order to assess the practicality and applicability of these guidelines. PMID:19189617

Background: The National Rural Health Mission (NRHM) in India relies on Accredited Social Health Activists (ASHAs) to act as a link between pregnant women and health facilities. All ASHAs are required to have a birth preparedness plan and be aware of danger signs of complications to initiate appropriate and timely referral to obstetric care. Objectives: To examine the extent to which Accredited Social Health Activists (ASHAs) are equipped with necessary knowledge and skills and the adequacy of support they get from supervisors to carry out their assigned tasks in a rural district in Karnataka, (South) India. Methods: A cross-sectional descriptive study was carried out among 225 ASHAs between June – July 2011. Quantitative and qualitative data were collected using pre-tested semi-structured interview schedule. The data were analyzed using SPSS version 17. Chi-square test was used to determine associations between categorical variables. Results: The response rate was 207(92%). In terms of knowledge of all key danger signs (Complication Readiness), 2(1%), 10(4.8%), and 15(7.2%) ASHAs were aware of key danger signs for labor and child birth, postpartum period and pregnancy period, respectively. Knowledge of key danger signs was associated with repeated, recent and practical training (p <0.05). A majority (71%) scored 4-7 of the maximum score out of 8 for knowledge regarding Birth Preparedness. Conclusions and PublicHealth Implications: ASHAs in rural Karnataka, India, are poorly equipped to identify obstetric complications and to help expectant mothers prepare a birth preparedness plan. There is critical need for the implementation of appropriate training and follow-up supervision of ASHAs within a supportive, functioning and responsive health care system.

The health of individuals occurs within the context of their environment and the other individuals they interact with in the communities they live in, work in and visit. Promoting the health of the public requires multiple strategies aimed at improving the environment, the health knowledge of groups and individuals, maintaining adequate food and water, and reducing the spread of disease. Many disciplines are needed to meet these goals, but the largest segment of the professional health work force required to meet these needs is nursing. Historically, nursing leaders in publichealth such as Florence Nightingale and Lillian Wald made significant inroads related to serious health issues because they were nurses. Today across the globe, nurses provide the key components of publichealth interventions including well baby care, health education, screening and immunization clinics, disaster management and emergency preparedness. With the growing nursing shortage in acute care settings, the brain drain of nurses from certain areas of the world, the shrinking public dollars for preventive health care, the nursing workforce needed to continue to provide these essential health care services is threatened. It is essential to put the spot light on nursing's role in publichealth with the hopes of attracting more public funds and more nurses to provide these essential services. PMID:20049229

With increasing population displacement and worsening water insecurity after the 2010 earthquake, Haiti experienced a large cholera outbreak. Our goal was to evaluate the strengths and weaknesses of seven community health facilities' ability to respond to a surge in cholera cases. Since 2010, Catholic Relief Services (CRS) with a number of public and private donors has been working with seven health facilities in an effort to reduce morbidity and mortality from cholera infection. In November 2012, CRS through the Centers for Disease Control and Prevention (CDC)'s support, asked the Johns Hopkins Center for Refugee and Disaster Response to conduct a cholera surge simulation tabletop exercise at these health facilities to improve each facility's response in the event of a cholera surge. Using simulation development guidelines from the Pan American Health Organization and others, a simulation scenario script was produced that included situations of differing severity, supply chain, as well as a surge of patients. A total of 119 hospital staff from seven sites participated in the simulation exercise including community health workers, clinicians, managers, pharmacists, cleaners, and security guards. Clinics that had challenges during the simulated clinical care of patients were those that did not appropriately treat all cholera patients according to protocol, particularly those that were vulnerable, those that would need additional staff to properly treat patients during a surge of cholera, and those that required a better inventory of supplies. Simulation-based activities have the potential to identify healthcare delivery system vulnerabilities that are amenable to intervention prior to a cholera surge. PMID:24481887

Publichealth and healthcare originally started out separately from one another in the past, having later further developed taking different paths in modern times. The major development the health systems underwent in the last half of the 20th century entailed a heightening of the individual standpoint and a division of these two approaches despite the attempts made to bring them together as of the WHO Alma-Ata Conference in 1978. The waning of rationalism and other social phenomena had a hand the collective or population-oriented focus being focused on to a lesser degree in PublicHealth, but these trends also gave rise to a growing problem of rationality in individual healthcare and sustainability in the publichealth systems. The debate on the current scene stands to set out the sustainability-related problems mediated by internal and external agents and to revise PublicHealth's possible contribution to the improvement thereof by advocating yet a further attempt at bringing together and integrating these two diverging standpoints. PMID:17193811

On 11 June 2009, the World Health Organization (WHO) declared that the world was in phase 6 of an influenza pandemic. In India, the first case of 2009 H1N1 influenza was reported on 16 May 2009 and by August 2010 (when the pandemic was declared over), 38 730 cases of 2009 H1N1 had been confirmed of which there were 2024 deaths. Here, we propose a conceptual model of the sources of health disparities in an influenza pandemic in India. Guided by a published model of the plausible sources of such disparities in the United States, we reviewed the literature for the determinants of the plausible sources of health disparities during a pandemic in India. We find that factors at multiple social levels could determine inequalities in the risk of exposure and susceptibility to influenza, as well as access to treatment once infected: (1) religion, caste and indigenous identity, as well as education and gender at the individual level; (2) wealth at the household level; and (3) the type of location, ratio of health care practitioners to population served, access to transportation and public spending on health care in the geographic area of residence. Such inequalities could lead to unequal levels of disease and death. Whereas causal factors can only be determined by testing the model when incidence and mortality data, collected in conjunction with socio-economic and geographic factors, become available, we put forth recommendations that policy makers can undertake to ensure that the pandemic preparedness plan includes a focus on social inequalities in India in order to prevent their exacerbation in a pandemic. PMID:22131367

Environmental PublicHealth Indicators (EPHIs), quantitative measures of health factors and environmental influences tracked over time, can be used to identify specific areas and populations for intervention and prevention efforts and to evaluate the outcomes of implemented polic...

There are significant shortages in the publichealth workforce and it's expected to worsen. Efforts to reduce this shortage are varied and include building the workforce by increasing exposure of students and young professionals in applied publichealth experiences. Providing these experiences increases productivity, and may help alleviate some of the workforce shortages in publichealth. This article seeks to highlight the work done at the Family Health Services Division (FHSD) in the Hawai‘i Department of Health over the past 6 and half years in working with students in epidemiology practicum and fellowship experiences. PMID:24660128

The article reviews the most important aspects of volcanic eruptions and presents a summary of the harmful materials they emit. The main health effects can be classified as either physical (trauma, respiratory diseases, etc.) or psychological (depression, anxiety, nightmares, neurosis, etc.). Popocatépetl, the most famous active volcano in Mexico, lies on the borders of the States of Mexico, Puebla and Morelos. In 1993, seismic activity intensified, as did as the emission of fumaroles, followed in December 1994 by moderate tremors and strong emissions of gases and ash. In 1996, a number of seismic events led to an unexpected explosion. A daily emission of 8,000 to 15,000 tonnes of sulfur dioxide has been measured. Popocatépetl is located in a densely populated region of Mexico. A complex network to monitor the volcano using sophisticated equipment has been set up, including visual surveillance, seismic, geochemical and geodesic monitoring. An early warning system (SINAPROC/CENAPRED) has been developed to keep the population permanently informed. The warning system uses colour codes: green for normal, yellow for alert, and red for warning and evacuation. An emergency plan has been prepared, including evacuation and preparation for medical centres and hospitals in the region, as well as intense public information campaigns. PMID:9170236

Background: Preparedness for disasters and emergencies at individual, community and organizational levels could be more effective tools in mitigating (the growing incidence) of disaster risk and ameliorating their impacts. That is, to play more significant roles in disaster risk reduction (DRR). Preparedness efforts focus on changing human behaviors in ways that reduce people’s risk and increase their ability to cope with hazard consequences. While preparedness initiatives have used behavioral theories to facilitate DRR, many theories have been used and little is known about which behavioral theories are more commonly used, where they have been used, and why they have been preferred over alternative behavioral theories. Given that theories differ with respect to the variables used and the relationship between them, a systematic analysis is an essential first step to answering questions about the relative utility of theories and providing a more robust evidence base for preparedness components of DRR strategies. The goal of this systematic review was to search and summarize evidence by assessing the application of behavioral theories to disaster and emergency healthpreparedness across the world. Methods: The protocol was prepared in which the study objectives, questions, inclusion and exclusion criteria, and sensitive search strategies were developed and pilot-tested at the beginning of the study. Using selected keywords, articles were searched mainly in PubMed, Scopus, Mosby’s Index (Nursing Index) and Safetylit databases. Articles were assessed based on their titles, abstracts, and their full texts. The data were extracted from selected articles and results were presented using qualitative and quantitative methods. Results: In total, 2040 titles, 450 abstracts and 62 full texts of articles were assessed for eligibility criteria, whilst five articles were archived from other sources, and then finally, 33 articles were selected. The Health Belief Model (HBM

Academic institutions possess tremendous resources that could be important for community disaster response and preparedness activities. In-depth exploration of the role of academic institutions in community disaster response has elicited information about particular academic resources leveraged for and essential to community preparedness and response; factors that contribute to the decision-making process for partner engagement; and facilitators of and barriers to sustainable collaborations from the perspectives of academic institutions, publichealth and emergency management agencies, and national association and agency leaders. The Academic-Community Partnership Project of the Emory University Preparedness and Emergency Response Research Center in collaboration with the Association of Schools of PublicHealth convened an invitational summit which included leadership from the National Association of County and City Health Officials, Association of State and Territorial Health Officials, Directors of PublicHealthPreparedness, Department of Health and Human Services Office of the Assistant Secretary for Preparedness and Response, CDC Office of PublicHealthPreparedness and Response, Association of Schools of PublicHealth, Association of American Medical Colleges, Association of Academic Health Centers, American Association of Colleges of Nursing, Council of State and Territorial Epidemiologists, and American Association of Poison Control Centers. From this convention, emerged recommendations for building and sustaining academic-publichealth-community collaborations for preparedness locally and regionally. PMID:25068939

Publichealth, once the gem of American social programs, has turned to dross. During the 20th century, the public-health sector wiped smallpox and polio off the U.S. map; virtually eliminated rickets, rubella, and goiter; stopped epidemic typhoid and yellow fever; and brought tuberculosis--once the leading cause of death in U.S. cities--under…

Thoroughly characterizing and continuously monitoring the publichealth workforce is necessary for ensuring capacity to deliver publichealth services. A prerequisite for this is to develop a standardized methodology for classifying publichealth workers, permitting valid comparisons across agencies and over time, which does not exist for the publichealth workforce. An expert working group, all of whom are authors on this paper, was convened during 2012-2014 to develop a publichealth workforce taxonomy. The purpose of the taxonomy is to facilitate the systematic characterization of all publichealth workers while delineating a set of minimum data elements to be used in workforce surveys. The taxonomy will improve the comparability across surveys, assist with estimating duplicate counting of workers, provide a framework for describing the size and composition of the workforce, and address other challenges to workforce enumeration. The taxonomy consists of 12 axes, with each axis describing a key characteristic of publichealth workers. Within each axis are multiple categories, and sometimes subcategories, that further define that worker characteristic. The workforce taxonomy axes are occupation, workplace setting, employer, education, licensure, certification, job tasks, program area, publichealth specialization area, funding source, condition of employment, and demographics. The taxonomy is not intended to serve as a replacement for occupational classifications but rather is a tool for systematically categorizing worker characteristics. The taxonomy will continue to evolve as organizations implement it and recommend ways to improve this tool for more accurate workforce data collection. PMID:25439251

An expert panel was convened in October 2007 at the International Society for Exposure Analysis Annual Meeting in Durham, NC, entitled “The Path Forward in Disaster Preparedness Since WTC—Exposure Characterization and Mitigation: Substantial Unfinished Business!” The panel prospectively discussed the critical exposure issues being overlooked during disaster responses and highlighted the needs for an optimal blending of exposure characterizations and hazard controls within disaster settings. The cases were made that effective and timely exposure characterizations must be applied during responses to any disaster, whether terrorist, manmade, or natural in origin. The consistent application of exposure sciences across acute and chronic disaster timelines will assure that the most effective strategies are applied to collect the needed information to guide risk characterization and management approaches. Exposure sciences must be effectively applied across all phases of a disaster (defined as rescue, reentry, recovery, and rehabitation—the four Rs) to appropriately characterize risks and guide risk-mitigation approaches. Failure to adequately characterize and control hazardous exposures increases the likelihood of excess morbidity and mortality. Advancing the infrastructure and the technologies to collect the right exposure information before, during, and immediately after disasters would advance our ability to define risks and protect responders and the public better. The panel provided conclusions, recommendations, and next steps toward effective and timely integration of better exposure science into disaster preparedness, including the need for a subsequent workshop to facilitate this integration. All panel presentations and a summary were uploaded to the ISES1 website (http://www.iseaweb.org/Disaster_Preparedness/index.php). PMID:18685563

Due to their access to medically underserved and vulnerable populations, community health centers (CHCs) can play an essential role in emergency response. CHCs often fill this role in partnership with other local health resources, such as local health departments (LHD). Little research has been done to understand the success of these partnerships as it relates to emergency planning and emergency response. This study compares CHC and LHD personnel regarding past, present, and future collaborative preparedness and response activities. Surveys were distributed electronically to 1,265 clinical and clerical staff at LHDs and CHCs in 23 states who met the study criteria. Of the 522 respondents, 287 (55%) reported having engaged in collaborative preparedness activities in general, with CHCs more likely to report partnering than LHDs. LHDs were more likely than CHCs to report taking part in specific preparedness activities, such as planning activities (91, 79%), (chi(2)(1, N = 280) = 7.395, P < 0.05), mass dispensing drill/exercises (65, 42%), (chi(2)(1, N = 279) = 14.019, P < 0.001), and communication drill/exercises (69, 47%), (chi(2)(1, N = 280) = 13.059, P < 0.001). This study suggests that collaborations between CHCs and LHDs in general are occurring, but these general collaboration are not being translated into participation in functional drills or exercises. Additional efforts to ensure a more comprehensive partnership between CHCs and LHDs in emergency preparedness are warranted. PMID:20379843

When the Fukushima Daiichi Nuclear Power Plant became crippled following Japan's March 2011 earthquake and tsunami, some U.S. citizens became concerned about whether radiation would disperse across the Pacific Ocean. As the Centers for Disease Control and Prevention prepared to assist in the U.S. response effort, ORAU provided the CDC with onsite, staff support at its Joint Information Center. ORAU also had a lead role in the development and execution of the CDC's first-ever Bridging the Gaps: PublicHealth and Radiation Emergency Preparedness conference, which took place 10 days after the earthquake and served as a forum for discussing the current state of radiation emergency preparedness.

In an era filled with fears of bioterrorism, Congress approved the Public Readiness and Emergency Preparedness Act (PREPA) to encourage development of vaccines and other countermeasures. By providing pharmaceutical manufacturers with protection from liability for potential side effects, Congress has attempted to motivate manufacturers to produce a national stockpile of countermeasures. As part of PREPA, the government established a compensatory system intended to provide compensation to persons injured by countermeasures used during a publichealth emergency. Although the Act provides for a compensation fund, it fails to allocate monies for that fund. Thus, in the absence of further congressional action, PREPA will not provide compensation to those injured by countermeasures. Failing to assure the American public of a compensation program constitutes bad public policy and risks inspiring potential vaccinees to refuse necessary drugs. Additionally, arguments as to the constitutionality of the Act exist should Congress fail to adequately fund the program, and the existence of those arguments undermines the purpose of the Act--namely to assure pharmaceutical manufacturers that they will not be sued into oblivion should they attempt to aid national pandemic protection. In addition to detailing both the Act and the statutory precedent for congressional attempts to spur biodefense, this Article addresses important issues of healthcare, tort, and constitutional law that will continue to manifest themselves in this new era of bioterrorism. PMID:17549932

This Panel Session consisted of five country reports (India, Indonesia, Maldives, Thailand, and Nepal) and the common issues identified during the Panel discussions relative to seismic events in the Southeast Asia Region. Important issues identified included the needs for: (1) a legal framework upon which to base preparedness and response; (2) coordination between the many organizations involved; (3) early warning systems within and between countries; (4) command and control; (5) access to resources including logistics; (6) strengthening the health infrastructure; (7) professionalizing the field of disaster medicine and management; (8) management of communications and information; (9) management of dead bodies; and (10) mental health of the survivors and health workers. PMID:17297912

We clarified the preparedness necessary to protect the health of community-dwelling vulnerable elderly people following natural disasters. We collected data from 304 community general support centres throughout Japan. We found the following in particular to be challenging: availability of disaster-preparedness manuals; disaster countermeasures and management systems; creation of lists of people requiring assistance following a disaster; evacuation support systems; development of plans for health management following disasters; provision of disaster-preparedness guidance and training; disaster-preparedness systems in the community; disaster information management; the preparedness of older people themselves in requiring support; and support from other community residents. PMID:27074407

Health professionals in community settings are generally unprepared for disasters. From 2006 to 2008 the California Statewide Area Health Education Center (AHEC) program conducted 90 table top exercises in community practice sites in 18 counties. The exercises arranged and facilitated by AHEC trained local coordinators and trainers were designed to assist health professionals in developing and applying their practice site emergency plans using simulated events about pandemic influenza or other emergencies. Of the 1,496 multidisciplinary health professionals and staff participating in the exercises, 1,176 (79%) completed learner evaluation forms with 92–98% of participants rating the training experiences as good to excellent. A few reported helpful effects when applying their training to a real time local disaster. Assessments of the status of clinic emergency plans using 15 criteria were conducted at three intervals: when the exercises were scheduled, immediately before the exercises, and for one-third of sites, three months after the exercise. All sites made improvements in their emergency plans with some or all of the plan criteria. Of the sites having follow up, most (N = 23) were community health centers that made statistically significant changes in two-thirds of the plan criteria (P = .001–.046). Following the exercises, after action reports were completed for 88 sites and noted strengths, weaknesses, and plans for improvements in their emergency plans Most sites (72–90%) showed improvements in how to activate their plans, the roles of their staff, and how to participate in a coordinated response. Challenges in scheduling exercises included time constraints and lack of resources among busy health professionals. Technical assistance and considerations of clinic schedules mitigated these issues. The multidisciplinary table top exercises proved to be an effective means to develop or improve clinic emergency plans and enhance the dialogue and

Funded by the Office of Economic Opportunity and carried out in Springfield, Massachusetts, during 1965-67, this training project sought to meet employment needs of disadvantaged high school graduates, the shortage of health professionals, and the need to improve and coordinate professional publichealth services. It combined a half-time,…

Availability of emergency preparedness funding between 2002 and 2009 allowed the North Dakota Department of Health to build publichealth response capabilities. Five of the 15 publichealthpreparedness capability areas identified by the Centers for Disease Control and Prevention in 2011 have been thoroughly tested by responses to flooding in North Dakota in 2009, 2010, and 2011; those capability areas are information sharing, emergency operations coordination, medical surge, material management and distribution, and volunteer management. Increasing response effectiveness has depended on planning, implementation of new information technology, changes to command and control procedures, containerized response materials, and rapid contract procedures. Continued improvement in response and maintenance of response capabilities is dependent on ongoing funding. PMID:23348522

The unimpeded functioning of hospital Health Information Services (HIS) is essential for patient care, clinical governance, organisational performance measurement, funding and research. In an investigation of hospital Health Information Services' preparedness for internal disasters, all hospitals in the state of Victoria with the following characteristics were surveyed: they have a Health Information Service/ Department; there is a Manager of the Health Information Service/Department; and their inpatient capacity is greater than 80 beds. Fifty percent of the respondents have experienced an internal disaster within the past decade, the majority affecting the Health Information Service. The most commonly occurring internal disasters were computer system failure and floods. Two-thirds of the hospitals have internal disaster plans; the most frequently occurring scenarios provided for are computer system failure, power failure and fire. More large hospitals have established back-up systems than medium- and small-size hospitals. Fifty-three percent of hospitals have a recovery plan for internal disasters. Hospitals typically self-rate as having a 'medium' level of internal disaster preparedness. Overall, large hospitals are better prepared for internal disasters than medium and small hospitals, and preparation for disruption of computer systems and medical record services is relatively high on their agendas. PMID:19546484

The Community Assessment Tool (CAT) for PublicHealth Emergencies Including Pandemic Influenza (hereafter referred to as the CAT) was developed as a result of feedback received from several communities. These communities participated in workshops focused on influenza pandemic planning and response. The 2008 through 2011 workshops were sponsored by the Centers for Disease Control and Prevention (CDC). Feedback during those workshops indicated the need for a tool that a community can use to assess its readiness for a disaster—readiness from a total healthcare perspective, not just hospitals, but the whole healthcare system. The CAT intends to do just that—help strengthen existing preparedness plans by allowing the healthcare system and other agencies to work together during an influenza pandemic. It helps reveal each core agency partners' (sectors) capabilities and resources, and highlights cases of the same vendors being used for resource supplies (e.g., personal protective equipment [PPE] and oxygen) by the partners (e.g., publichealth departments, clinics, or hospitals). The CAT also addresses gaps in the community's capabilities or potential shortages in resources. While the purpose of the CAT is to further prepare the community for an influenza pandemic, its framework is an extension of the traditional all-hazards approach to planning and preparedness. As such, the information gathered by the tool is useful in preparation for most widespread publichealth emergencies. This tool is primarily intended for use by those involved in healthcare emergency preparedness (e.g., community planners, community disaster preparedness coordinators, 9-1-1 directors, hospital emergency preparedness coordinators). It is divided into sections based on the core agency partners, which may be involved in the community's influenza pandemic influenza response.

In the late 1990s, the South Carolina Department of Health and Environmental Control (SCDHEC) was faced with the challenges of a workforce that was not prepared in publichealth; the impending loss of significant agency expertise, leadership, and institutional knowledge through retirement; the lack of available and accessible training; and continuing state budget cuts. Preparedness for bioterrorism and other publichealth emergencies was also of concern, a need made more urgent after 2001. To respond to current and emerging publichealth challenges, the SCDHEC had to have a workforce with the knowledge and skills necessary for the delivery of essential publichealth services. To address these challenges, the department partnered with the University of North Carolina in the pilot of the Management Academy for PublicHealth. The Management Academy is now integrated into the South Carolina workforce development strategy, and 199 staff members and 22 community partners have graduated from the program. Along with increased knowledge, skills, and abilities of individual staff and increased organizational and community capacity, a significant result of South Carolina's experience with the Management Academy for PublicHealth is the development of a training program for emergency preparedness modeled on the Management Academy. This highly successful program illustrates the replicability of the Management Academy model. PMID:16912610

In disaster-related events such as these, this survey demonstrates clear need for improved preparedness efforts and communication strategies to help reduce health risks for at-risk populations. The role of occupational health nurses and occupational and environmental medicine physicians requires knowledge and skills in many areas. This includes not only clinical skills related to illness and injury that will occur, but also skills in such areas as surveillance, management, community coordination, risk management and risk communication, and health protection. The psychological impact of disasters will have far-reaching effects resulting in emotional and behavioral changes requiring both immediate and long-term interventions. Comprehensive disaster management guidance should be in place to assist health care providers and workers in pre-event, event, and post-event phases of the disaster. PMID:17526297

An online questionnaire was developed to explore respiratory protective device (RPD) prevalence in U.S. health care facilities. The survey was distributed to professional nursing society members in 2014 and again in 2015 receiving 322 and 232 participant responses, respectively. The purpose of this study was to explore if the emergency preparedness climate associated with Ebola virus disease changed the landscape of RPD use and awareness. Comparing response percentages from the two sampling time frames using bivariate analysis, no significant changes were found in types of RPDs used in health care settings. N95 filtering facepiece respirators continue to be the most prevalent RPD used in health care facilities, but powered air-purifying respirators are also popular, with regional use highest in the West and Midwest. Understanding RPD use prevalence could ensure that health care workers receive appropriate device trainings as well as improve supply matching for emergency RPD stockpiling. PMID:27462029

U.S. schools of publichealth have recognized the imperative to strengthen the publichealth practice content of training for future publichealth practitioners. Five strategies to develop administrative and curriculum programs within schools of publichealth to address this need are described: (1) institution of centers for publichealth program evaluation; (2) creation of automated field placement and apprenticeship programs; (3) formalization of linkages with professional management training programs to create a track for future senior managers of community health agencies; (4) establishment of cross-departmental applied publichealth faculty tracks; and (5) offering applied publichealth evaluation scholarships for students. These initiatives may provide incentives for the institution of a publichealth practice focus within schools of publichealth. PMID:10186683

Historical assessments of the Occupation’s efforts to tackle enteric diseases (cholera, typhoid, paratyphoid and dysentery) have generally reflected a celebratory narrative of US-inspired publichealth reforms, strongly associated with the head of the PublicHealth and Welfare Section, Crawford F. Sams. Close inspection of the documentary record, however, reveals much greater continuity with pre-war Japanese publichealth practices than has hitherto been acknowledged. Indeed, there are strong grounds for disputing American claims of novelty and innovation in such areas as immunisation, particularly in relation to typhoid vaccine, and environmental sanitation, where disparaging comments about the careless use of night soil and a reluctance to control flies and other disease vectors reveal more about the politics of publichealth reform than the reality of pre-war practices. Likewise, the representation of American-inspired sanitary teams as clearly distinct from and far superior to traditional sanitary associations (eisei kumiai) was closer to propaganda than an accurate rendering of past and present developments. PMID:19048809

This manual supplies information helpful to individuals wishing to become certified in publichealth pest control. It is designed as a technical reference for vector control workers and as preparatory material for structural applicators of restricted use pesticides to meet the General Standards of Competency required of commercial applicators. The…

At the dawn of the 21st century, globalisation is a word that has become a part of everyday communication in all corners of the world. It is a concept that for some holds the promise of a new and brighter future, while for others it represents a threat that needs to be confronted and counteracted. In the area of publichealth, a wide range of claims have been made about the various impacts, both positive and negative, that can be attributed to globalisation. In the ever expanding literature on globalisation and health, it has become apparent that considerable confusion is emerging in both the ways that terminology is applied and concepts are defined. The determinants of health are increasingly multisectoral, and in tackling these challenges it is necessary to take a multidisciplinary approach that includes policy analyses in such areas as trade, environment, defence/security, foreign policy, and international law. In assembling the terms for this glossary, we have attempted to demonstrate the richness of the globalisation and publichealth debate, and in so doing have selected some of the core terms that require definition. We hope that this glossary will help to clarify this interesting and challenging area, and will also serve as a useful entry point to this new debate in publichealth. PMID:11801614

To examine the public's response to future terrorist attacks, we surveyed 1,001 New Yorkers in the community one year after the September 11 attacks. Overall, New Yorkers were very concerned about future terrorist attacks and also concerned about attacks involving biological or nuclear weapons. In addition, while most New Yorkers reported that if a biological or nuclear attack occurred they would evaluate available information before evacuating, a significant number reported they would immediately evacuate, regardless of police or publichealth communications to the contrary. The level of public concern was significantly higher on all measures among New York City and Long Island residents (downstate) compared to the rest of the state. A model predicting higher fear of terrorism indicated that downstate residents, women, those 45 to 64 years old, African Americans and Hispanics, those with less education/income, and those more likely to flee, were more fearful of future attacks. In addition, making disaster preparations and carefully evaluating emergency information also predicted a higher level of fear as well. A second model predicting who would flee suggested that those more likely to evaluate available information were less likely to immediately evacuate, while those with a higher fear of future attacks were more likely to flee the area. Given these findings and the possibility of future attacks, mental health professionals need to be more involved in preparedness efforts, especially related to the psychological impact of attacks involving weapons of mass destruction. PMID:14730761

Nanotechnology is developing very quickly, and Japan is in many respects leading the world in this convergence of nanoscale engineering techniques. The publichealth community in Japan must start to think about the publichealth impacts of nanotechnology over the next 20 years. The responsibility for the benefits and the harms of nanotechnology lies with government, with corporations and the business community, with scientists and specialists in all related fields, and with NPOs and the public. There are very many questions of publichealth which are not yet being asked about nanotechnology. If nanoparticles are to be used in cosmetics, food production and packaging, how will they react or interact with the human skin and organs? What chemical-toxic effects on life might there be from the nanoparticles in car tires and vehicle plastic mouldings when they are disposed of by incineration? Will they pass into the soil and groundwater and enter into the food-chain? It is now an urgent ethical demand, based on the precautionary principle, that Japan join the governments of the world to take an intergovernmental initiative to intervene in the further development, production and marketing of nanotechnological products with precautionary research and regulation. PMID:16408476

An emerging approach to publichealth emergency preparedness and response, community resilience encompasses individual preparedness as well as establishing a supportive social context in communities to withstand and recover from disasters. We examine why building community resilience has become a key component of national policy across multiple federal agencies and discuss the core principles embodied in community resilience theory—specifically, the focus on incorporating equity and social justice considerations in preparedness planning and response. We also examine the challenges of integrating community resilience with traditional publichealth practices and the importance of developing metrics for evaluation and strategic planning purposes. Using the example of the Los Angeles County Community Disaster Resilience Project, we discuss our experience and perspective from a large urban county to better understand how to implement a community resilience framework in publichealth practice. PMID:23678937

The paper questions the legitimacy and relevance of a potential emergence of any publichealth policies relating to sexology, as they exist for most of the major medical issues. It discusses the two major areas of intervention of sexology namely problems related to access to pleasure on the one hand, violence, abuse and other sexual perversions on the other hand. The legitimacy and relevance of publichealth policy to prevent the latter, i.e. sexual violence cannot be questioned. However, interventions to promote erotic skills are beyond the role and responsibility of the State but can be assigned to the civil society, especially community associations engaged in culture, solidarity and the promotion of social links in general. PMID:24734361

Brazil represents half of South America and one third of Latin America, having more than 186 million inhabitants. After China and India it is the third largest developing country in the world. The wealth is unequally distributed among the states and among the people. Brazil has a large and complex health care system. A Universal PublicHealth System (SUS: Sistema SPACEnico de Saúde) covers the medical expenses for 80% of the population. The genetic structure of the population is very complex, including a large proportion of tri- hybrid persons, genetic isolates, and a panmictic large majority. Genetic services are offered at 64 genetic centers, half of them public and free. Nationwide networks are operating for inborn errors of metabolism, oncogenetics, and craniofacial anomalies. The Brazilian Society of Medical Genetics (SBGM) has granted 120 board certifications since 1986, and 7 recognized residences in medical genetics are operating in the country. Three main publichealth actions promoted by the federal government have been undertaken in the last decade, ultimately aimed at the prevention of birth defects. Since 1999, birth defects are reported for all 3 million annual live births, several vaccination strategies aim at the eradication of rubella, and wheat and maize flours are fortified with folic acid. Currently, the government distributes over 2 million US dollars to finance 14 research projects aimed at providing the basis for the adequate prevention and care of genetics disorders through the SUS. Continuity of this proactive attitude of the government in the area of genomics in publichealth is desired. PMID:19023184

Geomatics technology has tremendous potential to address publichealth issues particularly under the present circumstances of global climate change and climate or technology induced human migration, which result in an increase in the geographical extent and re-emergence of vector-borne diseases. The authors present an overview of the science of geomatics, describe the potential impacts of climate change on vector-borne diseases and review the applications of remote sensing for disease vector surveillance. PMID:17193755

Background Health care providers play a significant role in large scale health emergency planning, detection, response, recovery and communication with the public. The effectiveness of health care providers in emergency preparedness and response roles depends, in part, on publichealth agencies communicating information in a way that maximizes the likelihood that the message is delivered, received, deemed credible and, when appropriate, acted on. However, during an emergency, health care providers can become inundated with alerts and advisories through numerous national, state, local and professional communication channels. We conducted an alert fatigue study as a sub-study of a larger randomized controlled trial which aimed to identify the most effective methods of communicating publichealth messages between publichealth agencies and providers. We report an analysis of the effects of publichealth message volume/frequency on recall of specific message content and effect of rate of message communications on health care provider alert fatigue. Methods Health care providers enrolled in the larger study (n=528) were randomized to receive publichealth messages via email, fax, short message service (SMS or cell phone text messaging) or to a control group that did not receive messages. For 12 months, study messages based on real events of publichealth significance were sent quarterly with follow-up telephone interviews regarding message receipt and topic recall conducted 5–10 days after the message delivery date. During a pandemic when numerous messages are sent, alert fatigue may impact ability to recall whether a specific message has been received due to the “noise” created by the higher number of messages. To determine the impact of “noise” when study messages were sent, we compared health care provider recall of the study message topic to the number of local publichealth messages sent to health care providers. Results We calculated the mean number of

contribute to protecting hospitals and practitioners who act in good faith from liability. Finally, to address anticipated staffing shortages during severe and prolonged disasters and pandemics, governments should develop approaches to formally expand the availability of qualified health-care workers, such as through using official foreign medical teams. CONCLUSIONS As a fundamental element of health-care and publichealth emergency planning and preparedness, the law underlies critical aspects of disaster and pandemic responses. Effective responses require comprehensive advance planning efforts that include assessments of complex legal issues and authorities. Recent disasters have shown that although law is a critical response tool, it can also be used to hold health-care stakeholders who fail to appropriately plan for or respond to disasters and pandemics accountable for resulting patient or staff harm. Claims of liability from harms allegedly suffered during disasters and pandemics cannot be avoided altogether. However, appropriate planning and legal protections can help facilitate sound, consistent decision-making and support response participation among health-care entities and practitioners. PMID:25144203

Independent and American Samoa have a shared cultural, genetic, ethnolinguistic, and historical background but have been politically separated since 1899. In this essay, we examine the health of these two polities and identify two key health patterns that have emerged even as American Samoa has achieved a higher per capita income than Independent Samoa. Whereas the gender gap in life expectancy at birth has narrowed in Independent Samoa, this gap has not narrowed in American Samoa and its male life expectancy now lags behind that of Independent Samoa. Neonatal mortality rates in American Samoa are slightly higher than in Independent Samoa. These patterns may be linked to the higher rates of obesity and urbanization observed in American Samoa compared to Independent Samoa, as well as the differing political and institutional arrangements of the two polities. Limited data remains a persistent challenge to conducting analysis of publichealth in the Pacific islands, particularly in American Samoa. PMID:26019989

Health education attitudes toward prevention, detection, and treatment of selected chronic diseases and conditions confronting publichealth nursing staffs were investigated at a Florida Department of Health and Rehabilitative Services District, which is composed of 16 county publichealth units (CPHU). Findings were used to determine type of…

In emergency response training, it is essential that the learners are able to apply their classroom knowledge and implement the practical and critical thinking skills they learned. A quasi-experimental methodology with a non-randomized control group and a pretest-posttest was used in this study to evaluate the training level of satisfaction as a…

The typical response of organizations dealing with external uncertainty is to develop strategies to adapt to the situation and focus on regaining a stable state. A crucial element of responding successfully to external uncertainties is to identify changes in knowledge needs within core organizational processes. This paper discusses the changing…

Martinique is a French island in the Lesser Antilles, with a high seismic hazard. In 2006, Martinican stakeholders involved in seismic safety formed the "Réplik" working group ("Aftershock" in French), the first of its kind in this region. This paper addresses a mid-term appraisal of the first seismic awareness campaign organised by Réplik from 2006 to 2011, and how it has modified, or not, local earthquake and tsunami preparedness. Despite efforts from Réplik to assess its efficiency through surveys, a growing gap is noted between the observed awareness and the actual preparedness of the public. As usual, gender, age, educational level, then boredom and saturation contribute to this discrepancy; strong cultural items may also influence the perception of actions. To remain efficient and respond to the public's expectations, Réplik must redirect its actions towards a cultural congruence of information: consideration of religion and local beliefs, comprehensive messages on TV and radio, use of the Creole language, participatory experiences and drills, and a little science. With this, the Réplik stakeholders can hope to increase Martinicans' involvement into the preparedness process, to cope quickly with a strong earthquake and this know-how can be shared with other seismically active islands in the Caribbean.

Approximately 7.6 million high school students in the United States participate in sports. Although most sport-related injuries in adolescents are considered minor emergencies, life-threatening illnesses or injuries may occur, such as sudden cardiac arrest, heat stroke, status asthmaticus and exercise-induced asthma, catastrophic brain injuries, cervical spine injuries, heat- and cold-related illness, blunt chest/abdominal injuries, and extremity fractures resulting in compartment syndrome. Emergency preparedness in athletics involves the identification of and planning for medical services to promote the safety of the athlete, to limit injury, and to provide medical care at the site of practice or competition. Several national organizations have published guidelines for emergency preparedness in school-based athletics. Our article reviews guidelines for emergency preparedness put forth by the Sideline Preparedness collaboration (comprised of 6 major professional associations, including the American Academy of Family Physicians, American Academy of Orthopedic Surgeons, American College of Sports Medicine, American Medical Society for Sports Medicine, American Orthopaedic Society for Sports Medicine, and American Osteopathic Academy of Sports Medicine), the National Athletic Trainers' Association, the American Academy of Pediatrics' Committee on School Health, and the American Heart Association. Additionally, we review published data examining compliance of US high schools with these recommendations for emergency preparedness in school-based athletics, determine deficiencies, and provide recommendations for improvement based on these deficiencies. PMID:23703513

Evolution and its elements of natural selection, population migration, genetic drift, and founder effects have shaped the world in which we practice publichealth. Human cultures and technologies have modified life on this planet and have coevolved with myriad other species, including microorganisms; plant and animal sources of food; invertebrate vectors of disease; and intermediate hosts among birds, mammals, and nonhuman primates. Molecular mechanisms of differential resistance or susceptibility to infectious agents or diets have evolved and are being discovered with modern methods. Some of these evolutionary relations require a perspective of tens of thousands of years, whereas other changes are observable in real time. The implications and applications of evolutionary understanding are important to our current programs and policies for infectious disease surveillance, gene–environment interactions, and health disparities globally. PMID:19966311

This paper sketches an account of publichealth ethics drawing upon established scholarship in feminist ethics. Health inequities are one of the central problems in publichealth ethics; a feminist approach leads us to examine not only the connections between gender, disadvantage, and health, but also the distribution of power in the processes of publichealth, from policy making through to programme delivery. The complexity of publichealth demands investigation using multiple perspectives and an attention to detail that is capable of identifying the health issues that are important to women, and investigating ways to address these issues. Finally, a feminist account of publichealth ethics embraces rather than avoids the inescapable political dimensions of publichealth. PMID:16731735

Reducing the occurrence of and influencing the rapid correction of food illness risk factors is a common goal for all governmental food regulatory programs nationwide. Foodborne illness in the United States is a major cause of personal distress, preventable illness, and death. To improve publichealth outcomes, additional workforce was required due to long standing staffing shortages and was obtained partially through consolidation of the Hawai‘i Department of Health's (HDOH) two food safety programs, the Sanitation Branch, and the Food & Drug Branch in July 2012, and through legislation that amended existing statutes governing the use of food establishment permit fees. Additionally, a more transparent food establishment grading system was developed after extensive work with industry partners based on three possible placards issued after routine inspections: green, yellow, and red. From late July 2014 to May 2015, there were 6,559 food establishments inspected statewide using the placard system with 79% receiving a green, 21% receiving a yellow, and no red placards issued. Sufficient workforce to allow timely inspections, continued governmental transparency, and use of new technologies are important to improve food safety for the public. PMID:26279966

Presented as an opening lecture of the new postgraduate education programme of both the Technical and the Free University of Berlin, sponsored by the German Federal Minister of Research and Technology, this lecture recalls the foundation of the first School of PublicHealth (The Johns Hopkins School of Hygiene and PublicHealth, Baltimore, Md., USA) by William Henry Welch, 75 years ago. Already in this early experience, several central topics of PublicHealth can be traced back: for instance the exact description of health problems of total population groups, the aetiological understanding of health problems as well as the transfer of knowledge in publichealth programmes. After a definition of the PublicHealth concept both in- and outside Germany, the article reviews three examples of core topics of PublicHealth. Drawing on results from the first report "Health of Zurich", applications of descriptive epidemiology for both priority finding in PublicHealth as well as aetiological research are illustrated. The second example, with data from a recent representative survey of adults swiss germans on the issue of discrimination against persons infected with HIV draws attention to the central importance of social sciences within PublicHealth. Finally, the third example discusses recent advances in health services research, including issues of health economics, an other important part of an interdisciplinary PublicHealth understanding. PMID:8451865

It is now recognized worldwide that anticipation and prevention of diseases have significant advantages for the health and healthy ageing of the population. Early recognition of the disease in a vulnerable population such as in children aged <5 years and adults aged >60 years enhances our preparedness for any eventualities and future burden of the diseases to society. It is also recognized that current publichealth practices alone cannot bring about the desired outcome. When tackling publichealth-related issues, such problems must be recognized and state-of-the-art principles and innovations from genomic sciences, information technologies, and medical specialties must be encompassed and embraced. These will enhance strategies for preparedness and provide us with a better understanding of how to identify, manage, and control disease burdens. The ever expanding landscape of genomics research also includes experimental and computational approaches for effectively utilizing DNA sequence information. From these perspectives, the intricacies of Mendelian single gene disorders are the least challenging compared to intricacies of multi-dimensional host factors for infectious diseases or complex disorders such as cancer. The concepts of publichealth in India are on firm footing; however, integration of contemporary advances to implement publichealth principles into practice has neither been attempted nor impacted on disease burden or our preparedness to prevent eventualities. At the same time, translational genomics is gradually paving the way for personalized medicine. Principles of personalized medicine remain to be fully understood and practiced despite the pharmacogenomics-based future of drug development, and treatment has not been as exciting as the advances in genomics we are witnessing today. The relevance, importance, and translational impediments of these advances will be discussed. PMID:26683060

Publichealth is a complex discipline that has contributed substantially to improving the health of the population. Publichealth action involves a variety of interventions and methods, many of which are now taken for granted by the general public. The specific focus and nature of publichealth interventions continue to evolve, but the fundamental principles of publichealth remain stable. These principles include a focus on the health of the population rather than of individuals; an emphasis on disease prevention rather than treatment; a goal of intervention at all vulnerable points in the causal pathway of disease, injury, or disability; and operation in a governmental rather than a private context. Publichealth practice occurs at local, state, and federal levels and involves various professional disciplines. Publichealth principles and practice are illustrated by a case study example of neural tube defects and folic acid. The application of information science and technology in publichealth practice provides previously unfathomed opportunities to improve the health of the population. Clinical informaticians and others in the health care system are crucial partners in addressing the challenges and opportunities offered by publichealth informatics. PMID:11687565

An expert panel was convened in October 2007 at the International Society for Exposure Analysis (ISEA) Annual Meeting in Durham, NC, entitled “The Path Forward in Disaster Preparedness Since WTC—Exposure Characterization and Mitigation: Substantial Unfinished Business!” The pane...

School shootings, such as Columbine, have prompted police executives to explore response tactics and preparedness efforts for combating active shooters. This qualitative exploratory case study focused on specific preparation initiatives that have been implemented for the purpose of dealing with active shooters. Being prepared is one of the only…

Media advocacy blends communications, science, politics, and advocacy to advance publichealth goals. In this article, we explain how media advocacy supports the social justice grounding of publichealth while addressing publichealth's "wicked problems" in the context of American politics. We outline media advocacy's theoretical foundations in agenda setting and framing and describe its practical application, from the layers of strategy to storytelling, which can illuminate publichealth solutions for journalists, policy makers, and the general public. Finally, we describe the challenges in evaluating media advocacy campaigns. PMID:24328989

The tragic April 19, 2015, death of an African American man injured while in police custody spurred several days of protest and civil unrest in Baltimore City. This article outlines the opportunity and role for a local health department during civil unrest, from the perspective of 2 emergency physicians who also led the Baltimore City Health Department through these recent events. Between April 27 and May 8, 2015, the Health Department was a lead agency in the unrest response and recovery activities. Similar to an emergency medical situation, a "publichealth code" is proposed as a model for centralizing, reacting to, and debriefing after situations of civil unrest. (Disaster Med PublicHealthPreparedness. 2016;10:293-295). PMID:26690654

This report documents issues related to the work of the Florida Comprehensive Health Professions Education Plan. Publichealth education prepares students for initial employment or advancement in a number of positions. While the publichealth work force is primarily employed in various units in local, state, and federal governments, industry also…

The effective functioning of any health system requires an efficient publichealth service. Every human being has the right to enjoy "the highest attainable standard of health," which can be fulfilled by giving every man an affordable and equitable health system he deserves and demands. In these years, complex health changes have complicated the situation in India. Most important gaps in the health care include an understanding of the burden of the disease and what leads to and causes ill health, the availability and use of appropriate technology in the management of disease, ill health and health systems that have an impact on service delivery. Universal Health Coverage (UHC) has the potential to increase economic growth, improve educational opportunities, reduce impoverishment and inequalities, and foster social cohesion. Steps taken for achieving UHC will address the publichealth challenges and vice versa. PMID:25116820

Background Worldwide, disaster exposure and consequences are rising. Disaster risk in New Zealand is amplified by island geography, isolation, and ubiquitous natural hazards. Wellington, the capital city, has vital needs for evacuation preparedness and resilience to the devastating impacts and increasing uncertainties of earthquake and tsunami disasters. While poor quality of life (QoL) is widely-associated with low levels of engagement in many health-protective behaviors, the relationships among health-related quality of life (HrQoL), well-being, and preparedness are virtually unknown. Methods We hypothesized that QoL and well-being affect household evacuation preparedness. We performed a quantitative epidemiologic survey (cross-sectional design) of Wellington adults. Our investigation assessed health-promoting attributes that build resiliency, conceptualized as health-protective attitudes and behaviors. Multidimensional QoL variables were measured using validated psychometric scales and analyzed for associations with evacuation preparedness, and we determined whether age and gender affected these relationships. Results We received 695 survey responses (28.5% response rate; margin of error ±3.8%; 80% statistical power to detect true correlations of 0.11 or greater). Correlational analyses showed statistically significant positive associations with evacuation preparedness for spiritual well-being, emotional well-being, and life satisfaction. No associations were found for mental health, social well-being, or gender; physical health was weakly negatively associated. Evacuation preparedness increased with age. Regression analyses showed that overall health and well-being explained 4.6-6.8% of the variance in evacuation preparedness. Spiritual well-being was the only QoL variable that significantly and uniquely explained variance in preparedness. Conclusions How well-being influences preparedness is complex and deeply personal. The data indicate that multidimensional

This article explores public relations effectiveness in publichealth institutions. First, the two major elements that comprise public relations effectiveness are discussed: reputation management and stakeholder relations. The factors that define effective reputation management are examined, as are the roles of issues and crisis management in building and maintaining reputation. The article also examines the major facets of stakeholder relations, including an inventory of stakeholder linkages and key audiences, such as the media. Finally, methods of evaluating public relations effectiveness at both the program level and the institutional level are explored. PMID:16521670

The Disaster Preparedness Task Force of the American Association for Geriatric Psychiatry was formed after Hurricane Katrina devastated New Orleans to identify and address needs of the elderly after the disaster that led to excess health disability and markedly increased rates of hopelessness, suicidality, serious mental illness (reported to exceed 60% from baseline levels), and cognitive impairment. Substance Abuse and Mental Health Services Administration (SAMHSA) outlines risk groups which fail to address later effects from chronic stress and loss and disruption of social support networks. Range of interventions recommended for Preparation, Early Response, and Late Response reviewed in the report were not applied to elderly for a variety of reasons. It was evident that addressing the needs of elderly will not be made without a stronger mandate to do so from major governmental agencies (Federal Emergency Management Agency [FEMA] and SAMHSA). The recommendation to designate frail elderly and dementia patients as a particularly high-risk group and a list of specific recommendations for research and service and clinical reference list are provided. PMID:20104050

Micro-organisms do not always exist in planctonic forms (single cells or small groups). To survive, especially in limiting media, they may adhere to inert or living surfaces. This enables them to multiply within a community protected by an extracellular matrix, thus forming a biofilm which protects them from antimicrobials. Biofilms have many potential consequences for publichealth. Some are positive, such as the commensal biofilms that protect against pathogenic bacteria, while environmental biofilms may be a source of outbreaks of respiratory or gastrointestinal diseases or infections associated with implanted medical devices. Respiratory tract infection can be caused by aerosols of fragmented biofilms growing in warm humid conditions (air cooling towers, hot springs, showers, etc.). Digestive tract infection can arise from biofilms formed during food manufacturing or packaging processes. Colonized implanted medical devices can lead to sepsis. This article examines the role of central venous catheters, taking into account the surgical site. In vivo studies show that the source of catheter infection may be exogenous or endogenous, while in vitro studies of biofilms show that ablation of the device is the best solution. Prevention is difficult, as biofilm formation is multifactorial. Physical and biological knowledge of biofilms may help to limit their formation and growth. PMID:22375373

Bioterrorism preparedness programs have contributed to death, illness, and waste of publichealth resources without evidence of benefit. Several deaths and many serious illnesses have resulted from the smallpox vaccination program; yet there is no clear evidence that a threat of smallpox exposure ever existed. The anthrax spores released in 2001 have been linked to secret US military laboratories-the resultant illnesses and deaths might not have occurred if those laboratories were not in operation. The present expansion of bioterrorism preparedness programs will continue to squander health resources, increase the dangers of accidental or purposeful release of dangerous pathogens, and further undermine efforts to enforce international treaties to ban biological and chemical weapons. The publichealth community should acknowledge the substantial harm that bioterrorism preparedness has already caused and develop mechanisms to increase our publichealth resources and to allocate them to address the world's real health needs. PMID:15451727

Legally, governments use their police powers to protect publichealth, safety, and welfare through zoning. This paper presents a case for revisiting zoning on the basis of increasing evidence that certain types of community design promote publichealth, as opposed to the dominant pattern of sprawl development, which does not. Zoning, and the land use planning linked to it, that prohibits or disfavors health-promoting community designs contradicts the inherent public policy goal on which it is based. If there is a paradigm shift underway, from traditional sprawl to health-promoting community designs, then health professionals and others should understand why zoning must be reassessed. PMID:14748317

The PublicHealth Programs and Services (PHP&S) Branch of the Los Angeles County Department of Health Services began a strategic planning effort in January 1986 to meet new disease trends, curb rising health care costs, consolidate limited resources, and handle shifting demographics. A strategic plan was designed to assess the opportunities and challenges facing the agency over a 5-year horizon. Priority areas were recognized, and seven strategic directives were formulated to guide PHP&S in expanding publichealth services to a changing community. Health promotion was acknowledged as a critical target of the strategic planning process. Among the most significant results of the health promotion directive was the establishment of an annual PublicHealth Week in Los Angeles County. Beginning in 1988, 1 week per year was selected to enhance the community's awareness of publichealth programs and the leadership role PHP&S plays in providing these programs to nearly 9 million residents of Los Angeles County. Events in PublicHealth Week include a professional lecture series and the honoring of an outstanding publichealth activist and a media personality who has fostered health promotion. Other free community activities such as mobile clinics, screenings, and health fairs are held throughout the county. With intensive media coverage of PublicHealth Week, PHP&S has been aggressive in promoting its own services and accomplishments while also educating the community on vital wellness issues. The strategic methodology employed by PHP&S, with its emphasis on long-range proactive planning, is receiving national recognition and could be adopted by similar agencies wishing to enhance their image and develop unique health promotion projects in their communities. PMID:1738801

The need for competency-based training for the publichealth workforce is well documented. However, human and financial resource limitations within publichealth agencies often make it difficult for publichealth practitioners to attend classroom-based training programs. The Internet is an increasingly popular way of extending training beyond the workforce. Although research describes attributes of effective online learning modules, much of the available training delivered via the Internet does not incorporate such attributes. The authors describe the On Your Time training series, an effective distance education program and training model for publichealth practitioners, which includes a standardized process for development, review, evaluation, and continuous quality improvement. On Your Time is a series of awareness-level (i.e., addressing what practitioners should know), competency-based training modules that address topics related to regulatory responsibilities of publichealth practitioners (e.g., assuring compliance with codes and regulations governing housing, retail food safety, private water supplies, hazardous and solid waste, on-site wastewater systems, etc.), publichealth surveillance, case investigation, disease prevention, health promotion, and emergency preparedness. The replicable model incorporates what is known about best practices for online training and maximizes available resources in the interests of sustainability. PMID:24578365

Each summer, one student from each vet school in the British Isles gets the chance to attend a week-long masterclass to learn more about veterinary publichealth. Last year, Hannah Clifford was one of them. Here she explains how her understanding of the relevance and responsibility of vets working in publichealth has changed. PMID:26851115

We propose a knowledge-based publichealth situation awareness system. The basis for this system is an explicit representation of publichealth situation awareness concepts and their interrelationships. This representation is based upon the users" (publichealth decision makers) cognitive model of the world, and optimized towards the efficacy of performance and relevance to the publichealth situation awareness processes and tasks. In our approach, explicit domain knowledge is the foundation for interpretation of publichealth data, as apposed to conventional systems where the statistical methods are the essence of the processes. Objectives: To develop a prototype knowledge-based system for publichealth situation awareness and to demonstrate the utility of knowledge intensive approaches in integration of heterogeneous information, eliminating the effects of incomplete and poor quality surveillance data, uncertainty in syndrome and aberration detection and visualization of complex information structures in publichealth surveillance settings, particularly in the context of bioterrorism (BT) preparedness. The system employs the Resource Definition Framework (RDF) and additional layers of more expressive languages to explicate the knowledge of domain experts into machine interpretable and computable problem-solving modules that can then guide users and computer systems in sifting through the most "relevant" data for syndrome and outbreak detection and investigation of root cause of the event. The Center for Biosecurity and PublicHealth Informatics Research is developing a prototype knowledge-based system around influenza, which has complex natural disease patterns, many publichealth implications, and is a potential agent for bioterrorism. The preliminary data from this effort may demonstrate superior performance in information integration, syndrome and aberration detection, information access through information visualization, and cross-domain investigation of the

The ends and means of publichealth activities are suggested to be at odds with the values held by human individuals and communities. Although promoting longer lives in better health for all seems like an endeavour that is obviously acceptable, it can be challenged by equally self‐evident appeals to autonomy, happiness, integrity and liberty, among other values. The result is that people's actual concerns are not always adequately dealt with by publichealth measures and assurances. PMID:16943332

Familiarize students affiliated with the Student National Medical Association with the National Library of Medicine's online resources that address medical conditions, health disparities, and publichealthpreparedness needs.

Publichealth agencies increasingly use electronic means to acquire, use, maintain, and store personal health information. Electronic data formats can improve performance of core publichealth functions, but potentially threaten privacy because they can be easily duplicated and transmitted to unauthorized people. Although such security breaches do occur, electronic data can be better secured than paper records, because authentication, authorization, auditing, and accountability can be facilitated. Publichealth professionals should collaborate with law and information technology colleagues to assess possible threats, implement updated policies, train staff, and develop preventive engineering measures to protect information. Tightened physical and electronic controls can prevent misuse of data, minimize the risk of security breaches, and help maintain the reputation and integrity of publichealth agencies. PMID:18382010

There have been tremendous advances in recent years in the innovative use of communication to address publichealth problems. This article outlines the use of communication techniques and technologies to (positively) influence individuals, populations, and organizations for the purpose of promoting conditions conducive to human and environmental health. The approaches described include social marketing, risk communication, and behavioral decision theory, entertainment education, media advocacy, and interactive decision support systems. We also address criticism of these approaches among publichealth professionals because of perceived discrepancies in their inherent goals and objectives. In conclusion, we call for the rapid diffusion of state-of-the-art publichealth communication practices into publichealth service agencies and organizations. PMID:7639871

Nearly half of all seafood consumed globally comes from aquaculture, a method of food production that has expanded rapidly in recent years. Increasing seafood consumption has been proposed as part of a strategy to combat the current non-communicable disease (NCD) pandemic, but publichealth, environmental, social, and production challenges related to certain types of aquaculture production must be addressed. Resolving these complicated human health and ecologic trade-offs requires systems thinking and collaboration across many fields; the One Health concept is an integrative approach that brings veterinary and human health experts together to combat zoonotic disease. We propose applying and expanding the One Health approach to facilitate collaboration among stakeholders focused on increasing consumption of seafood and expanding aquaculture production, using methods that minimize risks to publichealth, animal health, and ecology. This expanded application of One Health may also have relevance to other complex systems with similar trade-offs. PMID:25152863

Urban planning, also called city and regional planning, is a multidisciplinary field in which professionals work to improve the welfare of persons and communities by creating more convenient, equitable, healthful, efficient, and attractive places now and for the future. The centerpiece of urban planning activities is a "master plan," which can take many forms, including comprehensive plans, neighborhood plans, community action plans, regulatory and incentive strategies, economic development plans, and disaster preparedness plans. Traditionally, these plans include assessing and planning for community needs in some or all of the following areas: transportation, housing, commercial/office buildings, natural resource utilization, environmental protection, and health-care infrastructure. Urban planning and publichealth share common missions and perspectives. Both aim to improve human well-being, emphasize needs assessment and service delivery, manage complex social systems, focus at the population level, and rely on community-based participatory methods. Both fields focus on the needs of vulnerable populations. Throughout their development, both fields have broadened their perspectives. Initially, publichealth most often used a biomedical model (examining normal/abnormal functioning of the human organism), and urban planning often relied on a geographic model (analysis of human needs or interactions in a spatial context). However, both fields have expanded their tools and perspectives, in part because of the influence of the other. Urban planning and publichealth have been intertwined for most of their histories. In 1854, British physician John Snow used geographic mapping of an outbreak of cholera in London to identify a public water pump as the outbreak's source. Geographic analysis is a key planning tool shared by urban planning and publichealth. In the mid-1800s, planners such as Frederick Law Olmsted bridged the gap between the fields by advancing the concept

Global trade and international trade agreements have transformed the capacity of governments to monitor and to protect publichealth, to regulate occupational and environmental health conditions and food products, and to ensure affordable access to medications. Proposals under negotiation for the World Trade Organization’s General Agreement on Trade in Services (GATS) and the regional Free Trade Area of the Americas (FTAA) agreement cover a wide range of health services, health facilities, clinician licensing, water and sanitation services, and tobacco and alcohol distribution services. Publichealth professionals and organizations rarely participate in trade negotiations or in resolution of trade disputes. The linkages among global trade, international trade agreements, and publichealth deserve more attention than they have received to date. PMID:15623854

Global trade and international trade agreements have transformed the capacity of governments to monitor and to protect publichealth, to regulate occupational and environmental health conditions and food products, and to ensure affordable access to medications. Proposals under negotiation for the World Trade Organization's General Agreement on Trade in Services (GATS) and the regional Free Trade Area of the Americas (FTAA) agreement cover a wide range of health services, health facilities, clinician licensing, water and sanitation services, and tobacco and alcohol distribution services. Publichealth professionals and organizations rarely participate in trade negotiations or in resolution of trade disputes. The linkages among global trade, international trade agreements, and publichealth deserve more attention than they have received to date. PMID:15623854

Objectives Each of the nuclear power plants in the US is encircled by an Emergency Planning Zone (EPZ). Within each EPZ, government officials, utility professionals, emergency managers, and publichealth practitioners collectively conduct extensive planning, exercises, and outreach to better protect their communities in the event of a nuclear accident. Our objective was to conduct a cross-sectional study of off-site publichealthpreparedness within EPZs to better understand the dynamics of nuclear preparedness and uncover lessons for all-hazards preparedness. Methods Using a qualitative, interview-based method, we consulted 120 county emergency managers, state healthpreparedness officers, state radiation health officials, and industry officials from 17 EPZs in ten different states. Results Interviewees reflected that EPZ emergency preparedness is generally robust, results from strong public-private partnership between nuclear plants and emergency management agencies, and enhances all-hazard preparedness. However, there exist a few areas which merit further study and improvement. These areas include cross-state coordination, digital public communication, and optimizing the level of public education within EPZs. Conclusions This first-of-its-kind study provides a cross-sectional snapshot of emergency preparedness in the 10-mile EPZ surrounding nuclear power plants. PMID:26692825

The Superfund PublicHealth Evaluation Manual has been developed for use by a diverse audience, including EPA regional staff, state Superfund program staff, federal and state remedial contractors, and potentially responsible parties. Individuals having different levels of scienti...

Public-health regularly encounters serious ethical dilemmas, such as rationing scarce resources, influencing individuals to change their behaviour, and limiting freedom to diminish disease transmission. Yet unlike medical ethics, there is no agreed-upon framework for analysing these difficulties. We offer such a framework. It distinguishes three philosophical views, often invoked in public-health discourse: positions based on outcomes (utilitarianism), positions focused on rights and opportunities (liberalism), and views that emphasise character and virtue (communitarianism). We explore critical variations within each approach, and identify practical problems that arise in addressing the ethical dimensions of health policy. We conclude by examining challenges posed by the feminist argument of ethics-of-care and by postmodern views about the nature of ethics. Health professionals need enhanced skills in applied philosophy to improve the coherence, transparency, and quality of public deliberations over ethical issues inherent in health policy. PMID:11937202

The Next Generation Science Standards were released in 2013 and call for the inclusion of engineering design into the science classroom. This integration of science and engineering is very exciting for many people and groups in both fields involved, but a good bit of uncertainty remains about how prepared science teachers feel to teach engineering design. This study analyzes the history of science standards leading up to the Next Generation Science Standards, establishes key components of the engineering design, and lays the background for the study detailed in this report. A survey was given to several hundred public secondary science teachers in the state of Utah in which respondents were asked to report their feelings of preparedness on several aspects of engineering design. The findings of the study show that Utah teachers do not feel fully prepared to teach engineering design at the present time (2014).

Home visiting services are cost-effective and improve the health of children and families among those at increased risk. From 1985–2008, home visiting services in Hawai‘i were provided primarily through state funding of the Hawai‘i Healthy Start Program, but the program was severely reduced due to the economy and state budget changes over the past decade. The Maternal and Child Health Branch (MCHB) in the Family Health Services Division responded to these changes by seeking out competitive grant opportunities and collaborations in order to continue to promote home visiting services to those children and families in need. In 2010, the MCHB was awarded a federally funded Maternal, Infant and Early Childhood Home Visiting (MIECHV) grant for home visiting services to promote maternal, infant, and early childhood health, safety and development, strong parent-child relationships, and responsible parenting. In 2011, the MCHB was also awarded a competitive MIECHV development grant that funded the re-establishment of the hospital Early Identification program. Families in need of additional support identified through this program are referred for family strengthening services to a network of existing home visiting programs called the Hawai‘i Home Visiting Network (HHVN). The HHVN is supported by MIECHV and a small amount of state funds to assist programs with capacity building, training, professional development, quality assurance, and accreditation/certification support. The MIECHV grant requires that programs are evidence-based and address specific outcome measures and benchmarks. The HHVN provides home visiting services to families prenatally through 5 years of age that reside in specific at-risk communities, and is aimed at fostering positive parenting and reducing child maltreatment using a strength-based approach by targeting six protective factors: (1) social connections, (2) nurturing and attachment, (3) knowledge of parenting and child development, (4

Encouraged by the success of smoking denormalization strategies as a tobacco-control measure, publichealth institutions are adopting a similar approach to other health behaviors. For example, a recent controversial ad campaign in New York explicitly aimed to denormalize HIV/AIDS amongst gay men. Authors such as Scott Burris have argued that efforts like this are tantamount to stigmatization and that such stigmatization is unethical because it is dehumanizing. Others have offered a limited endorsement of denormalization/stigmatization campaigns as being justified on consequentialist grounds; namely, that the potential publichealth benefits outweigh any stigmatizing side effects. In this paper, I examine and reject the blanket condemnation of stigmatization efforts in publichealth. I argue that the moral status of such efforts are best evaluated within a contractualist, as opposed to a consequentialist, framework. Contractualism in publichealth ethics asks whether a particular stigmatizing policy could be justified to reasonable individuals who do not know whether they will be affected by that policy. Using this approach, I argue that it is sometimes permissible for publichealth institutions to engage in health-related stigmatization. PMID:21797912

Introduction Community Assessment for PublicHealth Emergency Response (CASPER) is an epidemiologic technique designed to provide quick, inexpensive, accurate, and reliable household-based publichealth information about a community’s emergency response needs. The Health Studies Branch at the Centers for Disease Control and Prevention (CDC) provides in-field assistance and technical support to state, local, tribal, and territorial (SLTT) health departments in conducting CASPERs during a disaster response and in non-emergency settings. Data from CASPERs conducted from 2003 through 2012 were reviewed to describe uses of CASPER, ascertain strengths of the CASPER methodology, and highlight significant findings. Methods Through an assessment of the CDC’s CASPER metadatabase, all CASPERs that involved CDC support performed in US states and territories from 2003 through 2012 were reviewed and compared descriptively for differences in geographic distribution, sampling methodology, mapping tool, assessment settings, and result and action taken by decision makers. Results For the study period, 53 CASPERs were conducted in 13 states and one US territory. Among the 53 CASPERS, 38 (71.6%) used the traditional 2-stage cluster sampling methodology, 10 (18.8%) used a 3-stage cluster sampling, and two (3.7%) used a simple random sampling methodology. Among the CASPERs, 37 (69.9%) were conducted in response to specific natural or human-induced disasters, including 14 (37.8%) for hurricanes. The remaining 16 (30.1%) CASPERS were conducted in non-disaster settings to assess household preparedness levels or potential effects of a proposed plan or program. The most common recommendations resulting from a disaster-related CASPER were to educate the community on available resources (27; 72.9%) and provide services (18; 48.6%) such as debris removals and refills of medications. In preparedness CASPERs, the most common recommendations were to educate the community in disaster

Human health so often depends on the health of the environment and wildlife around us. The presence of naturally occurring or human environmental contaminants and the emergence of diseases transferred between animals and humans are growing concerns worldwide. The USGS is a source of natural science information vital for understanding the quantity and quality of our earth and living resources. This information improves our understanding not only of how human activities affect environmental and ecological health, but also of how the quality of our environment and wildlife in turn affects human health. USGS is taking a leadership role in providing the natural science information needed by health researchers, policy makers, and the public to safeguard publichealth

The schedules that Americans live by are not consistent with healthy sleep patterns. In addition, poor access to educational and treatment aids for sleep leaves people engaging in behavior that is harmful to sleep and forgoing treatment for sleep disorders. This has created a sleep crisis that is a publichealth issue with broad implications for cognitive outcomes, mental health, physical health, work performance, and safety. New public policies should be formulated to address these issues. We draw from the scientific literature to recommend the following: establishing national standards for middle and high school start times that are later in the day, stronger regulation of work hours and schedules, eliminating daylight saving time, educating the public regarding the impact of electronic media on sleep, and improving access to ambulatory in-home diagnostic testing for sleep disorders. PMID:26581727

Digital government is typically defined as the production and delivery of information and services inside government and between government and the public using a range of information and communication technologies. Two types of government relationships with other entities are government-to-citizen and government-to-government relationships. Both offer opportunities and challenges. Assessment of a publichealth agency's readiness for digital government includes examination of technical, managerial, and political capabilities. Publichealth agencies are especially challenged by a lack of funding for technical infrastructure and expertise, by privacy and security issues, and by lack of Internet access for low-income and marginalized populations. Publichealth agencies understand the difficulties of working across agencies and levels of government, but the development of new, integrated e-programs will require more than technical change - it will require a profound change in paradigm. PMID:15675046

This special article defines the publichealth principles and core publichealth functions that are combined to produce the publichealth services essential for a highly-functioning New Zealand health system. The five core functions are: health assessment and surveillance; publichealth capacity development; health promotion; health protection; and preventive interventions. The core functions are interconnected and are rarely delivered individually. Publichealth services are not static, but evolve in response to changing needs, priorities, evidence and organisational structures. The core functions describe the different ways publichealth contributes to health outcomes in New Zealand and provide a framework for ensuring services are comprehensive and robust. PMID:26367356

Over half of the adults in Hawai‘i are overweight or obese, exposing them to increased risk for chronic diseases and resulting in higher health care expenses. Poor dietary habits and physical inactivity are important contributors to obesity and overweight. Because adults spend most of their waking hours at work, the workplace is an important setting for interventions to solve this growing problem. Changing the nutrition environment to support healthy eating is a recommended practice for worksite wellness interventions. Following this recommendation, the Hawai‘i State Department of Health (DOH) launched the Choose Healthy Now! Healthy Vending Pilot Project to increase access to healthy options in worksites. Choose Healthy Now! utilized an education campaign and a traffic light nutrition coding system (green = go, yellow = slow, red = uh-oh), based on federal nutrition guidelines, to help employees identify the healthier options in their worksite snack shops. Inventory of healthy items was increased and product placement techniques were used to help make the healthy choice the easy choice. DOH partnered with the Department of Human Services' Ho‘opono Vending Program to pilot the project in six government buildings on O‘ahu between May and September of 2014. Vendors added new green (healthy) and yellow (intermediate) options to their snack shop and cafeteria inventories, and labeled their snacks and beverages with green and yellow point-of-decision stickers. The following article outlines background and preliminary findings from the Choose Healthy Now! pilot. PMID:25414808

Most librarians know the importance of disaster preparedness. Many disasters could have been prevented altogether or have had reduced impact if institutions had been better prepared. This resource guide suggests how disaster preparedness can be achieved at cultural institutions. Twenty-three basic resource articles are presented to introduce…

There is increasing recognition of the role eHealth will play in the effective and efficient delivery of healthcare. This research challenges the assumption that students enter university as digital natives, able to confidently and competently adapt their use of information and communication technology (ICT) to new contexts. This study explored…

In this article, we compared the characteristics of public and private accredited publichealth training programs. We analyzed the distinct opportunities and challenges that publicly funded schools of publichealth face in preparing the nation's publichealth workforce. Using our experience in creating a new, collaborative public school of publichealth in the nation's largest urban public university system, we described efforts to use our public status and mission to develop new approaches to educating a workforce that meets the health needs of our region and contributes to the goal of reducing health inequalities. Finally, we considered policies that could protect and strengthen the distinct contributions that public schools of publichealth make to improving population health and reducing health inequalities. PMID:25706006

Environmental noise has increased to the point that it affects large numbers of people. The most consistently demonstrated health effect of exposure to noise is hearing impairment. Other effects, such as stress reaction, irritability, fatigue and disturbances to physiologic function have been seen in laboratory research but are highly individualized and restricted to such specific populations as industrial workers. Rising background sound levels in communities due to increased traffic flow, industralization, work saving machinery, and other noise sources have caused community noise levels to become dangerously high. This factor is complicated by exposure to high sound level recreational activities with greater frequency and for longer periods. Recognizing the existence of the problem, governmental agencies have begun to identify the scope of the problem, to designate standards and regulations controlling noise sources, and to regulate allowable noise exposure for workers. PMID:10297834

The New York City Department of Health and Mental Hygiene, The Community Health Care Association of New York State and Clinical Directors Network are collaborating on the "eClinician Project," which has distributed seven hundred publichealth-friendly, wireless (WiFi) enabled Personal Digital Assistants (PDAs) to primary care clinicians working in New York City, federally funded, Community Health Centers (CHC) which serve minority underserved communities that suffer a disproportionate burden of chronic disease and lack access to health promotion disease prevention services. Each participating health center also received a wireless router to create an onsite internet hot spot to enable clinicians to have internet access. The goals of the eClinician Project are to: 1) To encourage adoption of information technology among providers in Community Health Centers in New York City by providing PDAs as a first line strategy towards achieving this goal, 2) enhance access to information on emergency preparedness, 3) improve patient outcomes by providing PDA-based clinical decision-support tools that support evidence-based care, 4) encourage chronic care management and health promotion/disease prevention activities, and 5) increase productivity and efficiency. CHC clinicians have received a hands-on, on-site orientation to PDAs. Ongoing training has continued via online CME-accredited webcasts (see www.CDNetwork.org). Clinical decision-support tools are available for download via the eClinician project web portal (see www.eClinician.org ). Publichealth alerts can be delivered to the PDAs or to the clinicians' desktop computers. Pre and post training surveys, in addition to a case study, have been used to evaluate the population demographics, PDA adoption by the clinicians, clinician attitudes towards using PDAs, PDA influence on clinical-decision making and barriers to adoption of PDAs and information technology in general. PMID:17238459

Publichealth efforts have resulted in tremendous improvements in the health of individuals and communities. The foundation for effective publichealth interventions rests, in large part, on a well-trained workforce. Unfortunately there is a major shortage of publichealth physicians who are prepared to face today's publichealth challenges.…

In light of the exceptional circumstances that arose from hosting the Olympic Games in Athens in 2004 and from recent terrorist events internationally, Greece attributes the highest priority to security issues. According to its statutory role, the Greek Atomic Energy Commission is responsible for emergency preparedness and response in case of nuclear and radiological events, and advises the Government on the measures and interventions necessary to protect the public. In this context, the Commission participated in the Nuclear, Radiological, Biological, and Chemical Threat National Emergency Plan, specially developed for the Olympic Games, and coordinated by the Olympic Games Security Division. The objective of this paper is to share the experience gained during the organization of the Olympic Games and to present the nuclear security program implemented prior to, during, and beyond the Games, in order to prevent, detect, assess, and respond to the threat of nuclear terrorism. This program adopted a multi-area coverage of nuclear security, including physical protection of nuclear and radiological facilities, prevention of smuggling of radioactive materials through borders, prevention of dispersion of these materials into the Olympic venues, enhancement of emergency preparedness and response to radiological events, upgrading of the technical infrastructure, establishment of new procedures for assessing the threat and responding to radiological incidents, and training personnel belonging to several organizations involved in the National Emergency Response Plan. Finally, the close cooperation of Greek Authorities with the International Atomic Energy Agency and the U.S. Department of Energy, under the coordination of the Greek Atomic Energy Commission, is also discussed. PMID:16966875

This paper deals briefly with the historical development of the major movements and organizations dedicated to the preservation of the health and security of the American people. Statements of various national organizations on the need for integration of these various services for the protection of the indigent are presented, and the experience of one county department in San Mateo which operates a completely integrated department of publichealth and welfare is reviewed, giving the pros and cons of the operation of a number of disciplines through a single administration. The major advantage of an integrated department of this kind is that all the services having to do with human needs—the needs arising from emotional distress, economic reverses or illness—are combined under the direction of a physician. It is probable that failure of the health discipline to provide such services was a factor in the presentation of the Wagner Act in 1938 and the Wagner-Murray-Dingell Bill in 1943. Continued close cooperation between the various disciplines devoted to the protection of the health and welfare of American citizens can help in solving some of the current problems. PMID:13364660

Zoning, the most prevalent land use planning tool in the United States, has substantial implications for equity and publichealth. Zoning determines where various categories of land use may go, thereby influencing the location of resulting environmental and health impacts. Industrially zoned areas permit noxious land uses and typically carry higher environmental burdens than other areas. Using New York City as a case study, the author shows that industrial zones have large residential populations within them or nearby. Noxious uses tend to be concentrated in poor and minority industrial neighborhoods because more affluent industrial areas and those with lower minority populations are rezoned for other uses, and industrial zones in poorer neighborhoods are expanded. Zoning policies, therefore, can have adverse impacts on publichealth and equity. The location of noxious uses and the pollution they generate have ramifications for global publichealth and equity; these uses have been concentrated in the world's poorer places as well as in poorer places within more affluent countries. Planners, policymakers, and publichealth professionals must collaborate on a worldwide basis to address these equity, health, and land use planning problems. PMID:11441726

Zoning, the most prevalent land use planning tool in the United States, has substantial implications for equity and publichealth. Zoning determines where various categories of land use may go, thereby influencing the location of resulting environmental and health impacts. Industrially zoned areas permit noxious land uses and typically carry higher environmental burdens than other areas. Using New York City as a case study, the author shows that industrial zones have large residential populations within them or nearby. Noxious uses tend to be concentrated in poor and minority industrial neighborhoods because more affluent industrial areas and those with lower minority populations are rezoned for other uses, and industrial zones in poorer neighborhoods are expanded. Zoning policies, therefore, can have adverse impacts on publichealth and equity. The location of noxious uses and the pollution they generate have ramifications for global publichealth and equity; these uses have been concentrated in the world's poorer places as well as in poorer places within more affluent countries. Planners, policymakers, and publichealth professionals must collaborate on a worldwide basis to address these equity, health, and land use planning problems. PMID:11441726

Abstract In 2011, a small pilot bike share program was established in the town core of Kailua, Hawai‘i, with funding from the Hawai‘i State Department of Health. The Kailua system consisted of two stations with 12 bicycles, and the goal was to secure additional funding to expand the station network in the future. Community feedback consistently indicated support for the bike share program. However, system metrics showed low levels of usage, averaging 41.5 rides per month (2011–2014). From observational data, users were primarily tourists. With minimal local staff, the bike share program had limited resources for promotion and education, which may have hindered potential use by local residents. Management of station operations and bike maintenance were additional, ongoing barriers to success. Despite the challenges, the pilot bike share program was valuable in several ways. It introduced the bike share concept to Hawai‘i, thereby helping to build awareness and connect an initial network of stakeholders. Furthermore, the pilot bike share program informed the development of a larger bike share program for urban Honolulu. As limited information exists in the literature about the experiences of smaller bike share programs and their unique considerations, this article shares lessons learned for other communities interested in starting similar bike share programs. PMID:26535166

Shiga toxin-producing Escherichia coli (STEC) strains are the only pathogenic group of E. coli that has a definite zoonotic origin, with ruminants and, in particular, cattle being recognized as the major reservoir. Most human STEC infections are food borne, but the routes of transmission include direct contact with animals and a variety of environment-related exposures. Therefore, STEC publichealth microbiology spans the fields of medical, veterinary, food, water, and environmental microbiology, requiring a "One Health" perspective and laboratory scientists with the ability to work effectively across disciplines. Publichealth microbiology laboratories play a central role in the surveillance of STEC infections, as well as in the preparedness for responding to outbreaks and in providing scientific evidence for the implementation of prevention and control measures. This article reviews (i) how the integration of surveillance of STEC infections and monitoring of these pathogens in animal reservoirs and potential food vehicles may contribute to their control; (ii) the role of reference laboratories, in both the publichealth and veterinary and food sectors; and (iii) the publichealth perspectives, including those related to regulatory issues in both the European Union and the United States. PMID:26104435

This paper argues that analysing past publichealth policies calls for scholarship that integrates insights not just from medical history but from a broad range of historical fields. Recent studies of historic infectious disease management make this evident: they confirm that prior practices inhere in current perceptions and policies, which, like their antecedents, unfold amidst shifting amalgams of politics, culture, law and economics. Thus, explaining publichealth policy of the past purely in medical or epidemiological terms ignores evidence that it was rarely, if ever, designed solely on medical grounds at the time. PMID:23674428

Public-health issues regarding zoological collections and free-ranging wildlife have historically been linked to the risk of transmission of zoonotic diseases and accidents relating to bites or injection of venom or toxins by venomous animals. It is only recently that major consideration has been given worldwide to the role of the veterinary profession in contributing to investigating zoonotic diseases in free-ranging wildlife and integrating the concept of publichealth into the management activities of game preserves and wildlife parks. At the veterinary undergraduate level, courses in basic epidemiology, which should include outbreak investigation and disease surveillance, but also in population medicine, in infectious and parasitic diseases (especially new and emerging or re-emerging zoonoses), and in ecology should be part of the core curriculum. Foreign diseases, especially dealing with zoonotic diseases that are major threats because of possible agro-terrorism or spread of zoonoses, need to be taught in veterinary college curricula. Furthermore, knowledge of the principles of ecology and ecosystems should be acquired either during pre-veterinary studies or, at least, at the beginning of the veterinary curriculum. At the post-graduate level, master's degrees in preventive veterinary medicine, ecology and environmental health, or publichealth with an emphasis on infectious diseases should be offered to veterinarians seeking job opportunities in publichealth and wildlife management. PMID:17035205

Information production and its communication being a key publichealth activity, developing modern information systems is a precondition for its fulfilling these assignments. A national publichealth information system (NPHIS) is a set of human resources combined with computing and communication technologies. It enables data linkage and data coverage as well as undertaking information production and dissemination in an effective, standardized and safe way. The Croatian Institute of PublicHealth LAN/WAN modules are under development. Health Safety System, Health Workers Registry, and Digital Library are among the Institute's developmental priorities. Communication between NPHIS participants would unfold over the Internet by using every relevant data protection method. Web technology-based applications would be run on special servers. Between individual applications, use would be made of the transaction module of communication through an exchange of the HL7 standard-based xml messages. In the conditions of transition, the health system must make an optimal use of the resources, which is not feasible without applying modern information and communication technologies. PMID:16095199

Disasters, whether natural or man-made, usually are unpredictable. Efforts to reduce morbidity and mortality from a disaster should be put forth before it occurs. A brief survey is presented of the worst flood to occur in a hundred years that affected eight provinces in Southeast China. The disaster preparedness and response for Anhui Province, the hardest hit area, is summarized. The disaster preparedness was comprehensive, and cooperation was achieved among various specialties: military forces; firefighters; civil engineers; mechanics; police; provincial governors; the medical sectors; and so forth. Among these groups, the role of medical sectors was of great importance in reducing disease that would have resulted from such a disaster. The measures undertaken by the medical sectors included development of an organization to reduce the impact of disaster; training of medical personnel in techniques of rescue and in treatment of victims in disaster areas; development of a plan to assist the leadership in decision-making and establishing support for disaster preparedness; and maintaining sufficient capacity in general hospitals for the admission of victims from disaster areas. PMID:10155464

Sustainable approaches to crises, especially non-trauma-related publichealth emergencies, are severely lacking. At present, the Ebola crisis is defining the operational publichealth skill sets for infectious disease epidemics that are not widely known or appreciated. Indigenous and foreign medical teams will need to adapt to build competency-based curriculum and standards of care for the future that concentrate on publichealth emergencies. Only by adjusting and adapting specific operational publichealth skill sets to resource poor environments will it be possible to provide sustainable prevention and preparedness initiatives that work well across cultures and borders. PMID:25288216

Since 2004, the Italian Department for Civil Protection and the Ministry of Health have implemented a national program for the prevention of heat-health effects during summer, which to-date includes 34 major cities and 93% of the residents aged 65 years and over. The Italian program represents an important example of an integrated approach to prevent the impact of heat on health, comprising Heat Health Watch Warning Systems, a mortality surveillance system and prevention activities targeted to susceptible subgroups. City-specific warning systems are based on the relationship between temperature and mortality and serve as basis for the modulation of prevention measures. Local prevention activities, based on the guidelines defined by the Ministry of Health, are constructed around the infrastructures and services available. A key component of the prevention program is the identification of susceptible individuals and the active surveillance by General Practitioners, medical personnel and social workers. The mortality surveillance system enables the timely estimation of the impact of heat, and heat waves, on mortality during summer as well as to the evaluation of warning systems and prevention programs. Considering future predictions of climate change, the implementation of effective prevention programs, targeted to high risk subjects, become a priority in the publichealth agenda. PMID:20623023

This paper summarizes the recent progress in international publichealth in terms of publichealth challenges, infectious diseases prevention and control, disease surveillance, chronic and non-communicable disease prevention and treatment, global health, health literacy and precision medicine for the purpose to provide reference for the improvement of publichealth in China. PMID:26822634

This paper defends a distinctly liberal approach to publichealth ethics and replies to possible objections. In particular, I look at a set of recent proposals aiming to revise and expand liberalism in light of publichealth's rationale and epidemiological findings. I argue that they fail to provide a sociologically informed version of liberalism. Instead, they rest on an implicit normative premise about the value of health, which I show to be invalid. I then make explicit the unobvious, republican background of these proposals. Finally, I expand on the liberal understanding of freedom as non-interference and show its advantages over the republican alternative of freedom as non-domination within the context of publichealth. The views of freedom I discuss in the paper do not overlap with the classical distinction between negative and positive freedom. In addition, my account differentiates the concepts of freedom and autonomy and does not rule out substantive accounts of the latter. Nor does it confine political liberalism to an essentially procedural form. PMID:19655049

Health risks of major accidents with toxic chemicals need to be defined by: (i) nature, (ii) number and (iii) severity. (ad i) Health effects are conveniently categorized by nature into local (L)/systemic (S) and immediate (1)/delayed (2) (health effects). (ad ii) Derivation of population responses generally is unfeasible, instead exposure bands can be specified by effect-level. (ad iii) The continuum of health effects should be described in a global disability scale. The 4 D'-scale seems most appropriate: death (D{sub 1}), disability (D{sub 2}), discomfort (D{sub 3}), detectability (D{sub 4}). For use in disaster response health risk specifications should furthermore be: (1) transparent, (2) in line with the overall situational analysis and (3) congruent with mitigation. (-ad 1) Transparency can be improved by selecting one main sign/symptom by effect level for field instructions. (-ad 2) Situational analysis initially involves the source-area (what effect levels are found near the source ) and the outer limits of the effect area (feedback from telephone complaints mostly D{sub 4}). Otherwise, knowledge is needed of the ratio of exposures that lead to consecutive effect levels to assess the overall health impact by interpolation. Finally, the need to recognize high risk situations is emphasized: e.g. data bases with distributions of dispersion constraints (urban areas), penetration potentials into the housing-stock, concentrations of groups at high-risk (over time). (-ad 3) Mitigation is divided into: (a) protection of the public in a threatened area and (b) medical assistance.

Social marketing uses the principles and techniques of commercial marketing by applying them to the complex social context in order to promote changes (cognitive; of action; behavioral; of values) among the target population in the public interest. The advent of Internet has radically modified the communication process, and this transformation also involved medical-scientific communication. Medical journals, health organizations, scientific societies and patient groups are increasing the use of the web and of many social networks (Twitter, Facebook, Google, YouTube) as channels to release scientific information to doctors and patients quickly. In recent years, even Healthcare in Italy reported a considerable application of the methods and techniques of social marketing, above all for health prevention and promotion. Recently the association for health promotion "Social marketing and health communication" has been established to promote an active dialogue between professionals of social marketing and publichealth communication, as well as among professionals in the field of communication of the companies involved in the "health sector". In the field of prevention and health promotion it is necessary to underline the theme of the growing distrust in vaccination practices. Despite the irrefutable evidence of the efficacy and safety of vaccines, the social-cultural transformation together with the overcoming of compulsory vaccination and the use of noninstitutional information sources, have generated confusion among citizens that tend to perceive compulsory vaccinations as needed and safe, whereas recommended vaccinations as less important. Moreover, citizens scarcely perceive the risk of disease related to the effectiveness of vaccines. Implementing communication strategies, argumentative and persuasive, borrowed from social marketing, also for the promotion of vaccines is a priority of the health system. A typical example of the application of social marketing, as

OBJECTIVES: Interorganizational collaboration aimed at community health improvement is an expectation of local publichealth systems. This study assessed the extent to which such collaboration occurred within one state (Wisconsin), described the characteristics of existing partnerships, and identified factors associated with partnership effectiveness. METHODS: In Stage 1, local health department (LHD) directors in Wisconsin were surveyed (93% response rate). In Stage 2, LHDs completed self-administered mailed surveys for each partnership identified in Stage 1 (85% response rate). Two-level hierarchical logit regression methods were used to model relationships between partnership and LHD variables and partnership outcomes. Data from 924 partnerships associated with 74 LHDs were included in the analysis. RESULTS: Partnerships most frequently addressed tobacco prevention and control, maternal and child health, emergency planning, community assessment and planning, and immunizations. Partnering was most frequent with other government agencies, hospitals, medical practices or clinics, community-based organizations, and schools. Partnership effectiveness was predicted by having a budget, having more partners contributing financially, having a broader array of organizations involved, and having been in existence for a longer period of time. A government mandate to start the partnership was inversely related to successful outcomes. Characteristics of LHDs did not predict partnership effectiveness. CONCLUSIONS: Financial support, having a broader array of partners, and allowing sufficient time for partnerships to succeed contribute to partnership effectiveness. Further study-using objective outcome measures-is needed to examine the effects of organizational and community characteristics on the effectiveness of local publichealth system partnerships. PMID:15736335

This article outlines and discusses five categories of information about individual jails that should be considered before making general statements about jails. These are (a) the process by which individuals come to and are processed through the jail, (b) the size of the jail, (c) the region of the country where the jail is situated, (d) classification/assessment techniques, and (e) architecture and supervision styles. It is hoped that this discussion will generate a better understanding of the complexity of jail systems across the nation and help publichealth professionals better target their research, programs, and policies directed at the jail/community health nexus. PMID:20881141

The increasing number of requests for aesthetic surgery legitimately leads to the question of whether it can be covered by PublicHealth. If we look at the definition of the World Health Organization, the answer is without any doubt an affirmative one. However, economic considerations show that there is no social system in the world that covers aesthetic surgery, except for some definite interventions. Requests for aesthetic surgery occur in all social classes. It is a personal choice and a voluntary decision. It is no longer society who assists a sick or ill patient but it is the person that assumes the responsibility for himself. PMID:14599901

OBJECTIVE: In December 2001, an expert consultation convened by WHO identified strengthening national and global chemical incident preparedness and response as a priority. WHO is working towards this objective by developing a surveillance and response system for chemical incidents. This report describes the frequency, nature and geographical location of acute chemical incidents of potential international concern from August 2002 to December 2003. METHODS: Acute chemical incidents were actively identified through several informal (e.g. Internet-based resources) and formal (e.g. various networks of organizations) sources and assessed against criteria for publichealth emergencies of international concern using the then proposed revised International Health Regulations (IHR). WHO regional and country offices were contacted to obtain additional information regarding identified incidents. FINDINGS: Altogether, 35 chemical incidents from 26 countries met one or more of the IHR criteria. The WHO European Region accounted for 43% (15/35) of reports. The WHO Regions for Africa, Eastern Mediterranean and Western Pacific each accounted for 14% (5/35); South-East Asia and the Americas accounted for 9% (3/35) and 6% (2/35), respectively. Twenty-three (66%) events were identified within 24 hours of their occurrence. CONCLUSION: To our knowledge this is the first global surveillance system for chemical incidents of potential international concern. Limitations such as geographical and language bias associated with the current system are being addressed. Nevertheless, the system has shown that it can provide early detection of important events, as well as information on the magnitude and geographical distribution of such incidents. It can therefore contribute to improving global publichealthpreparedness. PMID:16462985

Skill in marketing is a scarce resource in publichealth, especially in developing countries. The Global Public–Private Partnership for Handwashing with Soap set out to tap the consumer marketing skills of industry for national handwashing programs. Lessons learned from commercial marketers included how to (1) understand consumer motivation, (2) employ 1 single unifying idea, (3) plan for effective reach, and (4) ensure effectiveness before national launch. After the first marketing program, 71% of Ghanaian mothers knew the television ad and the reported rates of handwashing with soap increased. Conditions for the expansion of such partnerships include a wider appreciation of what consumer marketing is, what it can do for publichealth, and the potential benefits to industry. Although there are practical and philosophical difficulties, there are many opportunities for such partnerships. PMID:17329646

Causal inference has a central role in publichealth; the determination that an association is causal indicates the possibility for intervention. We review and comment on the long-used guidelines for interpreting evidence as supporting a causal association and contrast them with the potential outcomes framework that encourages thinking in terms of causes that are interventions. We argue that in publichealth this framework is more suitable, providing an estimate of an action’s consequences rather than the less precise notion of a risk factor’s causal effect. A variety of modern statistical methods adopt this approach. When an intervention cannot be specified, causal relations can still exist, but how to intervene to change the outcome will be unclear. In application, the often-complex structure of causal processes needs to be acknowledged and appropriate data collected to study them. These newer approaches need to be brought to bear on the increasingly complex publichealth challenges of our globalized world. PMID:23297653

... PublicHealth Security and Bioterrorism Preparedness and Response Act of 2002, Subtitle A of Public Law...) that could pose a severe threat to publichealth and safety. The Agricultural Bioterrorism...

Exposure to noise constitutes a health risk. There is sufficient scientific evidence that noise exposure can induce hearing impairment, hypertension and ischemic heart disease, annoyance, sleep disturbance, and decreased school performance. For other effects such as changes in the immune system and birth defects, the evidence is limited. Most publichealth impacts of noise were already identified in the 1960s and noise abatement is less of a scientific but primarily a policy problem. A subject for further research is the elucidation of the mechanisms underlying noise-induced cardiovascular disorders and the relationship of noise with annoyance and nonacoustical factors modifying health outcomes. A high priority study subject is the effects of noise on children, including cognitive effects and their reversibility. Noise exposure is on the increase, especially in the general living environment, both in industrialized nations and in developing world regions. This implies that in the twenty-first century noise exposure will still be a major publichealth problem. Images Figure 2 PMID:10698728

A review of the literature is provided for the topic of health-related research and power frequency electromagnetic fields. Minimal evidence for concern is present on the basis of animal and plant research. General observation would accord with the implication that there is no single and manifest health effect as the result of exposure to these fields. There are persistent indications, however, that these fields have biologic activity, and consequently, there may be a deleterious component to their action, possibly in the presence of other factors. Power frequency electromagnetic field exposures are essentially ubiquitous in modern society, and their implications in the larger perspective of publichealth are unclear at this time. Electromagnetic fields represent a methodological obstacle for epidemiologic studies and a quandary for risk assessment; there is need for more data. PMID:3319560

On 11 March 2011, northern Japan was struck by first a magnitude 9.0 earthquake off the eastern coast and then by an ensuing tsunami. At the Fukushima Dai-ichi Nuclear Power Plant (NPP), these twin disasters initiated a cascade of events that led to radionuclide releases. Radioactive material from Japan was subsequently transported to locations around the globe, including the U.S. The levels of radioactive material that arrived in the U.S. were never large enough to cause health effects, but the presence of this material in the environment was enough to require a response from the publichealth community. Events during the response illustrated some U.S. preparedness challenges that previously had been anticipated and others that were newly identified. Some of these challenges include the following: (1) Capacity, including radiation health experts, for monitoring potentially exposed people for radioactive contamination are limited and may not be adequate at the time of a large-scale radiological incident; (2) there is no publichealth authority to detain people contaminated with radioactive materials; (3) publichealth and medical capacities for response to radiation emergencies are limited; (4) publichealth communications regarding radiation emergencies can be improved to enhance publichealth response; (5) national and international exposure standards for radiation measurements (and units) and protective action guides lack uniformity; (6) access to radiation emergency monitoring data can be limited; and (7) the Strategic National Stockpile may not be currently prepared to meet the publichealth need for KI in the case of a surge in demand from a large-scale radiation emergency. Members of the publichealth community can draw on this experience to improve publichealthpreparedness. PMID:25627948

On 11 March 2011, northern Japan was struck by first a magnitude 9.0 earthquake off the eastern coast and then by an ensuing tsunami. At the Fukushima Dai-ichi Nuclear Power Plant (NPP), these twin disasters initiated a cascade of events that led to radionuclide releases. Radioactive material from Japan was subsequently transported to locations around the globe, including the U.S. The levels of radioactive material that arrived in the U.S. were never large enough to cause health effects, but the presence of this material in the environment was enough to require a response from the publichealth community. Events during the response illustrated some U.S. preparedness challenges that previously had been anticipated and others that were newly identified. Some of these challenges include the following: (1) Capacity, including radiation health experts, for monitoring potentially exposed people for radioactive contamination are limited and may not be adequate at the time of a large-scale radiological incident; (2) there is no publichealth authority to detain people contaminated with radioactive materials; (3) publichealth and medical capacities for response to radiation emergencies are limited; (4) publichealth communications regarding radiation emergencies can be improved to enhance publichealth response; (5) national and international exposure standards for radiation measurements (and units) and protective action guides lack uniformity; (6) access to radiation emergency monitoring data can be limited; and (7) the Strategic National Stockpile may not be currently prepared to meet the publichealth need for KI in the case of a surge in demand from a large-scale radiation emergency. Members of the publichealth community can draw on this experience to improve publichealthpreparedness. PMID:25627948

In January 2003, the University of North Carolina Center for PublicHealthPreparedness established Team Epi-Aid to match graduate student volunteers with state and local health departments to assist with outbreaks and other applied publichealth projects. This study assessed whether Team Epi-Aid participation by full-time graduate students impacted post-graduation employment, particularly by influencing students to work in governmental publichealth upon graduation. In September 2010, 223 program alumni were contacted for an online survey and 10 selected for follow-up interviews. Eighty-three Team Epi-Aid alumni answered the survey (response rate = 37 %). Forty-one (49 %) reported participating in at least one activity, with 12/41 (29 %) indicating participation in Team Epi-Aid influenced their job choice following graduation. In 6 months prior to enrolling at UNC, 30 (36 %) reported employment in publichealth, with 16/30 (53 %) employed in governmental publichealth. In 6 months following graduation, 34 (41 %) reported employment in publichealth, with 27 (80 %) employed in governmental publichealth. Eight alumni completed telephone interviews (response rate = 80 %). Five credited Team Epi-Aid with influencing their post-graduation career. Experience in applied publichealth through a group such as Team Epi-Aid may influence job choice for publichealth graduates. PMID:23942945

With the increasing global frequency of disasters, the call for disaster preparedness training needs to be reinforced. Nurses form the largest group of the healthcare workforce and are often on the frontline in disaster management. Therefore, nurses should be adequately equipped with the knowledge and skills to respond to disasters, starting from their pre-service training to their in-service professional training. However, the inclusion of disaster preparedness education in undergraduate nursing curricula is minimal in most countries. The purpose of this article is to highlight the current state of nursing education and training in disaster management, both generally and in Oman. The significance of disaster preparedness training and recommendations for its inclusion in nursing practice and education are also discussed. PMID:26909207

Publichealth entomology focuses on the population biology of vector-borne infections, seeking to understand how such pathogens perpetuate over time and attempting to devise methods for reducing the burden that they impose on human health. As publichealth entomology passes its centennial, a series of pervasive research themes and spirited debates characterize the discipline, many reflecting a tension between field and laboratory research. In particular, institutional support for population-based research and training programs has fallen behind that for those using modern lab-based approaches. Discussion of modes of intervention against vector-borne infections (such as deployment of genetically modified vectors, the role of DDT in malaria control, host-targeted acaricides for Lyme disease risk reduction, and truck-mounted aerosol spraying against West Nile virus transmission) illustrates the discipline's need for strengthening population-based research programs. Even with the advent of molecular methods for describing population structure, the basis for anophelism without malaria (or its eastern North American counterpart, ixodism without borreliosis) remains elusive. Such methods have not yet been extensively used to examine the phylogeography and geographical origins of zoonoses such as Lyme disease. Basic ecological questions remain poorly explored: What regulates vector populations? How may mixtures of pathogens be maintained by a single vector? What factors might limit the invasion of Asian mosquitoes into North American sites? Putative effects of "global warming" remain speculative given our relative inability to answer such questions. Finally, policy and administrative issues such as the "no-nits" dictum in American schools, the Roll Back Malaria program, and legal liability for risk due to vector-borne infections serve to demonstrate further the nature of the crossroads that the discipline of publichealth entomology faces at the start of the 21st Century

The violent reactions of some members of the intellectual class with regard to certain political aspects of the fight against smoking oblige us to pose the general problem of the legitimacy of centralised publichealth decisions. There are three sources of legitimacy for intervention by public authorities: the existence of an externality (the risk that each imposes on the other by his or her behaviour); the invisibility of the risk in the eyes of non-professionals; the technical impossibility of individual protection against the risk. The unequal distribution of risk could be a fourth criteria of legitimate public action but one can also consider inequity as an automatic consequence of the existence of one or more of the first three conditions when they concern the less educated, less affluent, and less influential. The "hygiene" period of preventive policy, at the end of the 19th Century in Europe, corresponds to the strong externalities because of the contagiousness of infectious diseases and the patient inability to treat them in the curative domain. On the other hand, the ability to appreciate the risks, reflecting significant social differences, seems inversely proportional to the expectations of individuals toward the State. The demand for the liberty to protect oneself from health risks is all the stronger when individuals have the cognitive and material means to effectively do so. The fight against smoking thus must constantly update the external negative effects of smoking and the setbacks in curing the ill that it creates.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7749645

The South East Asian Tsunami in Thailand and Hurricane Katrina in the United States were natural disasters of different origin but of similar destruction and response. Both disasters exhibited synonymous health outcomes and similar structural damage from large surges of water, waves, and flooding. A systematic discussion and comparison of the disasters in Thailand and the Gulf Coast considers both calamities to be similar types of disaster in different coastal locations. Thus valuable comparisons can be made for improvements in response, preparedness and mitigation. Research needs are discussed and recommendations made regarding potential methologies. Recommendations are made to: (1) improve disaster response time in terms of needs assessments for publichealth and environmental data collection; (2) develop an access-oriented data sharing policy; and (3) prioritize natural geomorphic structures such as barrier islands, mangroves, and wetlands to help reduce the scale of future natural disasters. Based on the experiences gained opportunities to enhance disaster preparedness through research are presented. PMID:19151433

The South East Asian Tsunami in Thailand and Hurricane Katrina in the United States were natural disasters of different origin but of similar destruction and response. Both disasters exhibited synonymous health outcomes and similar structural damage from large surges of water, waves, and flooding. A systematic discussion and comparison of the disasters in Thailand and the Gulf Coast considers both calamities to be similar types of disaster in different coastal locations. Thus valuable comparisons can be made for improvements in response, preparedness and mitigation. Research needs are discussed and recommendations made regarding potential methologies. Recommendations are made to: (1) improve disaster response time in terms of needs assessments for publichealth and environmental data collection; (2) develop an access-oriented data sharing policy; and (3) prioritize natural geomorphic structures such as barrier islands, mangroves, and wetlands to help reduce the scale of future natural disasters. Based on the experiences gained opportunities to enhance disaster preparedness through research are presented. PMID:19151433

... Home Current Issue Past Issues Celebrating Leadership in PublicHealth and Medicine Friends of the National Library of ... 2009 FNLM Annual Awards Dinner celebrated advances in publichealth and medicine, along with the individuals and organizations ...

As a global influenza pandemic appears imminent with the spread of avian influenza, the California Department of Health Services (CDHS) and the California Distance Learning Health Network (CDLHN) presented a live 90-min satellite broadcast and subsequent 2-hr small group problem-solving tabletop exercise to practice interventions needed to minimize the consequences of a pandemic event. Publichealth nurses (PHNs), managers, and other staff in laboratories, clinical care, veterinary medicine, environmental health, public information and safety, emergency management, and transportation down linked the program, broadcast by satellite from the CDHS Richmond Laboratory Campus, to view on-site locally. PHNs represented the professional category with the highest number of participants for those conducting the program outside of California. For those in California, PHNs represented the professional category with the second highest number of participants. Participants and distance-learning facilitators completed a training evaluation survey. Continuing education credits were provided by the Centers for Disease Control and Prevention to participants who completed the satellite broadcast evaluation. This distance-learning-by-satellite method of education paired with an activities-based tabletop exercise, and a focus on local rather than State-based responsibility, marks an innovative method of training PHNs and other staff in emergency preparedness response. PMID:17214655

Developments in medicine and constitutional law dictate modification of publichealth legislation in the United States. Traditionally overlooked by legislators, present publichealth laws provide inadequate decision-making criteria and inappropriate procedures for dealing with issues. Revised legislation should provide health care officials and agencies with the tools to balance individual rights against publichealth necessities. This Article makes four recommendations for legislative reform: (1) remove artificial legislative distinction between venereal and other communicable diseases; (2) provide criteria defining "publichealth necessity" to limit discretionary exercise of police power by health officials; (3) provide strong confidentiality protections in the collection and storage of publichealth information; (4) empower publichealth officials to select from a graded series of less restrictive alternatives in dealing with publichealth problems. PMID:3451680

This paper describes and analyses the publichealth system response to the deadly earthquake in Sichuan province, China, in May 2008. Drawing on an experiential learning project consisting of a literature review and field research, including a series of interviews with medical and publichealth professionals, policy-makers and first responders, a conceptual framework was developed to describe the response. This approach emphasises the pre-existing preparedness level of the medical and publichealth systems, as well as social, economic and geo-political factors that had an impact on mitigation efforts. This framework was used to conduct post-disaster analyses addressing major response issues and examining methods employed during the publichealth response to the disaster. This framework could be used to describe and analyse the emergency response to other disasters. PMID:25196335

Clinical experience is consistently emphasized in research findings as the primary influence in encouraging more positive attitudes to mental health nursing. The available research, however, presents two major limitations. First, it does not measure the specific factors that might contribute to a positive clinical experience. Second, it does not consider the relationship between clinical experience and attitudes towards people experiencing a mental illness or towards mental health nursing. This is the second of a two-part paper presenting findings from a statewide survey of undergraduate nursing students in Victoria. A pre-/post-test design was used to measure the impact of clinical experience on the following subscales: (i) attitudes towards people experiencing a mental illness; (ii) attitudes toward mental health nursing; and (iii) preparedness for mental health practice. Subscale (iv) satisfaction with clinical experience was also measured in the post-test phase. The findings demonstrated an improvement on all three subscales in the post-test phase and a high level of satisfaction with clinical experience. Furthermore, a relationship between all four subscales was evident. PMID:18789043

West Africa is currently experiencing the largest outbreak of Ebola virus disease (EVD) in history with intense transmission in several affected countries. For non-affected countries, the best protective measures are adequate levels of preparedness including vigilant surveillance to detect cases early and well prepared health systems to ensure rapid containment of the virus and to avoid further spread. The World Health Organization Regional Office for the Western Pacific recently conducted two activities: a web-based EVD preparedness survey and an EVD simulation exercise to determine the overall level of EVD preparedness in the Region. The survey and exercise together demonstrate there is a good overall level of preparedness for a potential imported case of EVD in the Western Pacific Region. However, several areas still require further strengthening before the Region can efficiently and effectively respond to potential EVD events, including laboratory testing arrangements; clinical management and infection prevention and control; and publichealth intervention measures, particularly at points of entry. Importantly, the survey and exercise also highlight the unique situation in Pacific island countries and emphasize that special considerations are needed to better support these countries in EVD preparedness. PMID:25960926

West Africa is currently experiencing the largest outbreak of Ebola virus disease (EVD) in history with intense transmission in several affected countries. For non-affected countries, the best protective measures are adequate levels of preparedness including vigilant surveillance to detect cases early and well prepared health systems to ensure rapid containment of the virus and to avoid further spread. The World Health Organization Regional Office for the Western Pacific recently conducted two activities: a web-based EVD preparedness survey and an EVD simulation exercise to determine the overall level of EVD preparedness in the Region. The survey and exercise together demonstrate there is a good overall level of preparedness for a potential imported case of EVD in the Western Pacific Region. However, several areas still require further strengthening before the Region can efficiently and effectively respond to potential EVD events, including laboratory testing arrangements; clinical management and infection prevention and control; and publichealth intervention measures, particularly at points of entry. Importantly, the survey and exercise also highlight the unique situation in Pacific island countries and emphasize that special considerations are needed to better support these countries in EVD preparedness. PMID:25960926

In 1993 the Massachusetts Department of PublicHealth (MDPH) began defining essential components of school health service programs, consistent with the publichealth model. The MDPH designed and funded the Enhanced School Health Service Programs to develop 4 core components of local school health services: (a) strengthening the administrative…

Analysis of the relationship between publichealth and the health system requires definition of a conceptual framework and the choice of a particular context. The chosen context of this discussion is the management of public organizations. With this in mind, functions will be associated with organizational macroprocesses. From this point of view, this article identifies the functions-processes that any health system should develop and their goals. The current situation of publichealth in the health system is analyzed through the study of publichealth budgets and the place they occupy in the hierarchy of the health departments of the autonomous communities. The "publichealth" budget program represents an average of 1.34% of health expenditure in the autonomous communities in 2010. Over 20% of publichealth organizations of the autonomous communities have a rank lower than general directorate. These data indicate the low weight assigned to publichealth in the health systems of the Spanish state. To change this situation, consensus must be reached on the desired relationship between publichealth and the health system. Such a consensus would then have to be accepted and work would have to be undertaken to improve results. Three alternatives are proposed: (i) publichealth would be an organization that would be above or outside the health system; (ii) publichealth would be synonymous with the publichealth system; and (iii) publichealth would form part of the health system with a range of assigned functions. Finally, we provide some recommendations to help define the most effective and efficient relationship between publichealth and the health system. PMID:20970219

Zoonotic infections are important sources of human disease; most known emerging infections are zoonotic (e.g., HIV, Ebola virus, severe acute respiratory syndrome, Nipah virus, and enteropathogenic Escherichia coli) and originated as natural infections of other species that acquired opportunities to come in contact with humans. There are also serious infectious diseases classically considered zoonotic, such as influenza, rabies, bubonic plague, brucellosis, and leptospirosis. More recently, it has been recognized that wildlife constitutes a particularly important source of novel zoonoses. With all this microbial movement, surveillance is considered the first line of publichealth defense. The zoonotic origin of many human and livestock infections argues strongly for the synergistic value of a One Health approach, which provides the capability to identify pathogens crossing into new species and could provide earlier warning of potential epidemics. This article discusses publichealth surveillance and major recent surveillance initiatives and reviews progress toward implementing a One Health surveillance framework. Networks discussed include global intergovernmental organizations and recent combined efforts of these organizations; Web-based nongovernmental systems (e.g., ProMED, the Program for Monitoring Emerging Diseases); and networks of bilateral or multilateral government programs (e.g., the CDC's Global Disease Detection [GDD] platform; the U.S. Department of Defense's Global Emerging Infections Surveillance and Response System [GEIS]; regional and subregional networks; and the U.S. Agency for International Development's Emerging Pandemic Threats [EPT] program and its surveillance component, PREDICT). Syndromic surveillance also has potential to complement existing systems. New technologies are enabling revolutionary capabilities for global surveillance, but in addition to serious technical needs, both sustainability and data-sharing mechanisms remain

... one app. Text GETEMERGENCY to 90999 or search "Red Cross Emergency" in the Apple App Store or Google Play Store . Prepare for Hurricanes Are You Ready for a Hurricane? Ruben Brown of the American Red Cross helps a family assemble a preparedness kit ...

The September 11, 2001 terrorist attacks on the World Trade Center and continued conflict in Middle Eastern countries has provoked a strong interest in issues of national security. On December 13, 2002 the Bush Administration announced its smallpox vaccination policy, the first nationwide "proactive" measure to address the threat of bioterrorism. The Program has received mixed reactions as a result of partisan issues, tensions in publichealth policy and federal and state jurisdiction, conflicting scientific views, and different risk assessments. The slow pace of the program, the difficulties surrounding its implementation, and the debates regarding its validity serves as a "case study" to demonstrate current short-comings in federal and state anti-terrorist and publichealth policies. The focus will be on the states' publichealth laws and emergency preparedness plans through an analysis of the proposed Model State Emergency Preparedness Act. Updating current publichealth laws combined with increased funding of scientific research and the foresight to act "proactively" will reach far beyond improving national security. These efforts serve the dual purpose of deterring future terrorist attacks while greatly improving responses to a number of other health emergencies and disasters. PMID:15460560

On September 4, 2011, a wildfire ignited in Bastrop County, Texas, resulting in losses of 34,068 acres of land and 1,645 homes and 2 deaths. At the request of the Texas Department of State Health Services Health Service Region 7 and the Bastrop County Office of Emergency Management, Community Assessments for PublicHealth Emergency Response (CASPER) were conducted in the weeks following the wildfire and again 3.5 years later to assess both the immediate and long-term publichealth and preparedness impacts of the wildfire. The objective of these assessments was to learn more about the trajectory of disaster recovery, including rebuilding, evacuation, household emergency planning, and mental and physical health outcomes among both adults and children. In 2015, households exposed to the 2011 wildfires were significantly more likely to have established a family meeting place and evacuation route, to have confidence in the local government's ability to respond to disaster, and to report symptoms of depression and higher stress. Longitudinal assessments using the CASPER method can provide actionable information for improved planning, preparedness, and recovery to publichealth and emergency management agencies and community residents. PMID:27081889

Joint efforts by fields of publichealth in the last decade have advocated use of the built environment to protect health. Past involvement by publichealth advocates in urban policy, however, has had mixed results. Although publichealth has significantly contributed to health improvements, its participation in urban renewal activities was problematic. Health advocates and the American PublicHealth Association produced guidelines that were widely used to declare inner-city areas blighted and provided a scientific justification for demolishing neighborhoods and displacing mostly poor and minority people. Furthermore, health departments failed to uphold their legal responsibility to ensure that relocated families received safe, affordable housing alternatives. These failures have important implications for future health-related work on the built environment and other core publichealth activities. PMID:19608955

After fall 2001, scientists and professionals recognized the importance of integrating publichealth with traditional first-response professions in planning and training for disasters. However, operationalizing this approach among professionals in the field confronted barriers that were both inter-cultural and jurisdictional. The Pennsylvania Preparedness Leadership Institute (PPLI) is a collaboration of the Pennsylvania Department of Health and the University of Pittsburgh Center for PublicHealthPreparedness. Team members are recruited from publichealth, emergency medicine, emergency management, hospitals, and public safety agencies from each of nine multi-county regions in Pennsylvania. Each team takes on a year-long project that addresses a strategic problem as a focus for capacity-building within its region. Unexpectedly during PPLI's first year in operation, a hepatitis-A outbreak tested whether one regional team could successfully mount the necessary integrated response. This experience, as well as the planned evaluation for PPLI, demonstrated both the successful processes and the positive impact of this integrated leadership training initiative. PMID:16025714

This mixed methods study examined the relationship between the motivations for attending college of undergraduate students with a focus on students with a publichealth major, and their desire to pursue graduate training in publichealth and subsequently, publichealth careers. The study highlighted the current publichealth workforce shortage and…

Reviews of publichealth emergency responses have identified a need for crisis leadership skills in health leaders, but these skills are not routinely taught in publichealth curricula. To develop criteria for crisis leadership in publichealth, published sources were reviewed to identify attributes of successful crisis leadership in aviation, public safety, military operations, and mining. These sources were abstracted to identify crisis leadership attributes associated with those disciplines and compare those attributes with crisis leadership challenges in publichealth. Based on this review, the following attributes are proposed for crisis leadership in publichealth: competence in publichealth science; decisiveness with flexibility; ability to maintain situational awareness and provide situational assessment; ability to coordinate diverse participants across very different disciplines; communication skills; and the ability to inspire trust. Of these attributes, only competence in publichealth science is currently a goal of publichealth education. Strategies to teach the other proposed attributes of crisis leadership will better prepare publichealth leaders to meet the challenges of publichealth crises. PMID:24274133

Emergency medicine (EM) has an important role in publichealth, but the ideal approach for teaching publichealth to EM residents is unclear. As part of the national Regional PublicHealth-Medicine Education Centers-Graduate Medical Education initiative from the CDC and the American Association of Medical Colleges, three EM programs received funding to create publichealth curricula for EM residents. Curricula approaches varied by residency. One program used a modular, integrative approach to combine publichealth and EM clinical topics during usual residency didactics, one partnered with local publichealth organizations to provide real-world experiences for residents, and one drew on existing national as well as departmental resources to seamlessly integrate more publichealth-oriented educational activities within the existing residency curriculum. The modular and integrative approaches appeared to have a positive impact on resident attitudes toward publichealth, and a majority of EM residents at that program believed publichealth training is important. Reliance on pre-existing community partnerships facilitated development of publichealth rotations for residents. External funding for these efforts was critical to their success, given the time and financial restraints on residency programs. The optimal approach for publichealth education for EM residents has not been defined. PMID:21961671

Background Ethics is a discipline, which primarily deals with what is moral and immoral behavior. PublicHealth Ethics is translation of ethical theories and concepts into practice to address complex multidimensional publichealth problems. The primary purpose of this paper was to conduct a narrative literature review-addressing role of ethics in developing curriculum in programs and schools of publichealth, ethics-related instruction in schools and programs of publichealth and the role of ethics in developing a competent publichealth workforce. Methods: An open search of various health databases including Google scholar and Ebscohost yielded 15 articles related to use of ethics in publichealth practice or publichealth training and the salient features were reported. Results: Results indicated a variable amount of ethics’ related training in schools and programs of publichealth along with publichealth practitioner training across the nation. Bioethics, medical ethics and publichealth ethics were found to be subspecialties’ needing separate ethical frameworks to guide decision making. Conclusions: Ethics based curricular and non-curricular training for emerging publichealth professionals from schools and programs of publichealth in the United States is extremely essential. In the current age of publichealth challenges faced in the United States and globally, to have an ethically untrained publichealth force is arguably, immoral and unethical and jeopardizes population health. There is an urgent need to develop innovative ethic based curriculums in academia as well as finding effective means to translate these curricular competencies into publichealth practice. PMID:23113159

War and terrorism, which are inseparable, cause death and disability, profound psychological damage, environmental destruction, disruption of the health infrastructure, refugee crises, and increased interpersonal, self-directed and collective violence. Weapons systems such as weapons of mass destruction and landmines have their own specific devastating effects. Preparation for war and preparedness for terrorism bring constraints on civil liberties and human rights, increase militarism, and divert resources from health care and from other needed services. War and terrorism may be best prevented through addressing their causes, which include limited resources, injustice, poverty and ethnic and religious enmity, and through strengthening the United Nations and the treaties controlling specific weapons systems, particularly weapons of mass destruction. In particular, the United States should cease its interference in the internal affairs of other nations and its advocacy of unilateral pre-emptive war. PMID:18771191

This paper explores the relationship between public housing, health outcomes, and health behaviors among low-income housing residents. While public housing can be a dangerous and unhealthy environment in which to live, the subsidized rent may free up resources for nutritious food and health care. In addition, public housing may be of higher…

Radiological and nuclear incidents are low probability but very high risk events. Measures can be, and have been, implemented to limit or prevent the impact on the public. Preparedness, however, remains the key to minimizing morbidity and mortality. Incidents may be related to hospital-based mis-administration of radiation in interventional radiology or nuclear medicine, industrial or nuclear power plant accidents. Safety and security measures are in place to prevent or mitigate such events. Despite efforts to prevent them, terrorist-perpetrated incidents with, for example, a radiological dispersal device (RDD) are also possible. Due to a misunderstanding of, or lack of, formal education regarding things in this realm, there can be considerable anxiety, even fear, about radiation-related incidents. Multiple studies evaluating healthcare provider willingness to report to work rank radiation as the hazard that will keep the largest number of workers at home. Even incidents that do not constitute a disaster can spiral out of control quite rapidly, placing considerable demands on community resources. Our communities will face these threats in the future and it is the responsibility of physicians and allied healthcare personnel to be trained and ready to care for those affected. The scope of resources needed to prepare for and respond to such incidents is indeed vast. It encompasses the coordinated effort of first responders and physicians, the preparedness of national agencies involved in responding to such events, and individual community cooperation and solidarity. This article reviews the approach to the short- and long-term effects of a radiological or nuclear incident on an affected population, with a specific focus on the medical and publichealth issues. It also summarizes the strengths and weaknesses of our current ability to respond effectively and makes recommendations to improve these capabilities. PMID:25348384

Heat waves are deadly weather-related exposures in the U.S. and account for more deaths annually than hurricanes, tornadoes, floods, and earthquakes combined. From a publichealth perspective, all morbidity and mortality associated with extreme heat events are completely preventable. Related environmental events that can impact health-poor air quality, concentrations of greenhouse gases, and the inability to cool at night-are all expected to increase in severity and frequency over this next century. Northrop Grumman's active program of climate science combines inputs from publichealth, population health analytics, advanced agent-based modeling and simulation, and high performance computing to assist the characterization of how climate change impacts human health in specific geographies. In this study, we defined heat waves as 3+ consecutive days when the high temperature is 10+ degrees (Fahrenheit) higher than the mean summer high temperature. To address current deficiencies in local planning and decision making with respect to regional climate change and its effect on human health, our research focused on performing a dynamical downscaling with the Weather Research and Forecasting (WRF) model to develop decision aids that translate the regional climate data into actionable information for users. WRF was run in nested mode at spatial resolution of 108 km, 36 km and 12 km and 28 vertical levels. We used WRF simulated temperatures at 2 meters above the surface to calculate the annual average number of days spent in heat waves. Our results indicated a significant increase in heat wave episodes-a direct consequence of steadily increasing maximum temperatures in the future. Our discussion continues with clarification of how publichealth must become integral to future community, civic, healthcare, and emergency preparedness planning. While continued growth in the number of persons living in urban areas will result in increased exposure to heat-related health risks

Herein we summarize the publichealth actions taken to mitigate exposure of the public to radiation after the Fukushima accident that occurred on 11 March 2011 in order to record valuable lessons learned for disaster preparedness. Evacuations from the radiation-affected areas and control of the distribution of various food products contributed to the reduction of external and internal radiation exposure resulting from the Fukushima incident. However, risk communication is also an important issue during the emergency response effort and subsequent phases of dealiing with a nuclear disaster. To assist with their healing process, sound, reliable scientific information should continue to be disseminated to the radiation-affected communities via two-way communication. We will describe the essential publichealth actions following a nuclear disaster for the early, intermediate and late phases that will be useful for radiological preparedness planning in response to other nuclear or radiological disasters. PMID:25862700

Herein we summarize the publichealth actions taken to mitigate exposure of the public to radiation after the Fukushima accident that occurred on 11 March 2011 in order to record valuable lessons learned for disaster preparedness. Evacuations from the radiation-affected areas and control of the distribution of various food products contributed to the reduction of external and internal radiation exposure resulting from the Fukushima incident. However, risk communication is also an important issue during the emergency response effort and subsequent phases of dealiing with a nuclear disaster. To assist with their healing process, sound, reliable scientific information should continue to be disseminated to the radiation-affected communities via two-way communication. We will describe the essential publichealth actions following a nuclear disaster for the early, intermediate and late phases that will be useful for radiological preparedness planning in response to other nuclear or radiological disasters. PMID:25862700

Unfortunately, disasters occur. We cannot always know the effects ahead of time, but we do know that lives can be lost, property damaged, and publichealth and home care agencies may not be able to provide the normal standard of care. Studies have shown that disaster preparedness content is limited in U.S. nursing programs (). Given the magnitude of recent natural disasters, such as the Japanese earthquake and tsunami in 2011, these findings are alarming. The increasing demands on healthcare providers in response to emergencies force home healthcare clinicians to identify their roles and responsibilities in emergency preparedness. This article discusses 1 model of disaster response and the role of the home healthcare provider at each stage. It further guides home healthcare nurses in creating a personal and professional plan, enabling them to understand how to minimize the impact of disasters and address the needs of their patients and those close to them. PMID:21987023

Twenty-three publichealth schools and 492 university schools of nursing were surveyed to gather specific information on educational programs related to nuclear war. Twenty publichealth schools and 240 nursing schools responded. Nuclear war-related content was most likely to appear in disaster nursing and in environmental health courses. Three schools of publichealth report that they currently offer elective courses on nuclear war. Innovative curricula included political action projects for nuclear war prevention.

This article summarizes several health initiatives in Kansas that are being forwarded by way of public/private partnerships. Consensus is being shaped on the standardization of health data and use of actionable indicators. Statewide publichealth improvement planning is also being pursued. A group of large employers and state agencies are creating a basis for group purchasing, consumer assessments of health plans, and coordinated public policy formulation. PMID:9718510

It is increasingly recognized that effective and appropriate data sharing requires the development of models of good data-sharing practice capable of taking seriously both the potential benefits to be gained and the importance of ensuring that the rights and interests of participants are respected and that risk of harms is minimized. Calls for the greater sharing of individual-level data from biomedical and publichealth research are receiving support among researchers and research funders. Despite its potential importance, data sharing presents important ethical, social, and institutional challenges in low-income settings. In this article, we report on qualitative research conducted in five low- and middle-income countries exploring the experiences of key research stakeholders and their views about what constitutes good data-sharing practice. PMID:26297744

Developing countries have been peasant societies. The cities in traditional societies have been pilgrimage centres, seats of administration and educational centres. These cities had homogeneous relationships with the villages. Industrialization has developed modern megacities whose way of life is heterogeneous with that in the villages. Rural poverty has pushed villagers to the cities, which were never planned to accommodate immigrants. Publichealth and social problems have arisen lowering the quality of life. Communicable diseases among the urban poor coexist with non-communicable diseases among the comparatively affluent. Problems of pollution, crime and chronic morbidity increase. The NGOs provide relief to the poor and needy but do nothing toward creating an infrastructure for balanced development. The election of women as a result of non-discriminatory legislation provides good ground for hope. PMID:8545672

The recent Deepwater Horizon oil spill and Japanese earthquake/tsunami radiation disaster have increased public concerns regarding the publichealth impact of industrial disasters. Industrial disasters are known to impose a unique set of challenges for publichealth emergency response. There are critical gaps in scientific knowledge regarding assessment and control of publichealth disasters related to industrial releases of hazardous materials. There is also a fundamental lack of familiarity regarding industrial disasters among the publichealth and medical communities, in general. There are few sources in the current publichealth literature that review this disaster phenomenon in a comprehensive manner. This article offers a review of the publichealth impact and unique considerations related to industrial disasters. PMID:22235598

School nurses (SNs) use publichealth nursing knowledge and skills to provide nursing services to school populations. The PublicHealth Intervention Wheel is a practice framework that can be used to explain and guide publichealth nursing interventions. SNs who were also members of the National Association of School Nurses completed an electronic survey on their use of publichealth interventions as defined by the wheel. Although 67% of the participants were not familiar with the PublicHealth Intervention Wheel, respondents reported conducting activities that were consistent with the Wheel interventions. Screening, referral and follow-up, case management, and health teaching were the most frequently performed interventions. Intervention use varied by educational level, age of nurse, years of practice, and student population. The PublicHealth Intervention Wheel is a relevant and useful framework that provides a language to explain population-based school nursing practice. PMID:26404552

Publichealth nursing has a code of ethics that guides practice. This includes the American Nurses Association Code of Ethics for Nurses, Principles of the Ethical Practice of PublicHealth, and the Scope and Standards of PublicHealth Nursing. Human rights and Rights-based care in publichealth nursing practice are relatively new. They reflect human rights principles as outlined in the Universal Declaration of Human Rights and applied to publichealth practice. As our health care system is restructured and there are new advances in technology and genetics, a focus on providing care that is ethical and respects human rights is needed. Publichealth nurses can be in the forefront of providing care that reflects an ethical base and a rights-based approach to practice with populations. PMID:23586767

The personality trait of neuroticism refers to relatively stable tendencies to respond with negative emotions to threat, frustration, or loss. Individuals in the population vary markedly on this trait, ranging from frequent and intense emotional reactions to minor challenges to little emotional reaction even in the face of significant difficulties. Although not widely appreciated, there is growing evidence that neuroticism is a psychological trait of profound publichealth significance. Neuroticism is a robust correlate and predictor of many different mental and physical disorders, comorbidity among them, and the frequency of mental and general health service use. Indeed, neuroticism apparently is a predictor of the quality and longevity of our lives. Achieving a full understanding of the nature and origins of neuroticism, and the mechanisms through which neuroticism is linked to mental and physical disorders, should be a top priority for research. Knowing why neuroticism predicts such a wide variety of seemingly diverse outcomes should lead to improved understanding of commonalities among those outcomes and improved strategies for preventing them. PMID:19449983

Many industries commonly use quality improvement (QI) techniques to improve service delivery and process performance. Yet, there has been scarce application of these proven methods to publichealth settings and the publichealth field has not developed a set of shared principles or a common definition for quality improvement. This article discusses a definition of quality improvement in publichealth and describes a continuum of quality improvement applications for publichealth departments. Quality improvement is a distinct management process and set of tools and techniques that are coordinated to ensure that departments consistently meet the health needs of their communities. PMID:20009636

Emergency medicine (EM) has an important role in publichealth, but the ideal approach for teaching publichealth to EM residents is unclear. As part of the national regional public health–medicine education centers-graduate medical education (RPHMEC-GM) initiative from the CDC and the American Association of Medical Colleges, three EM programs received funding to create publichealth curricula for EM residents. Curricula approaches varied by residency. One program used a modular, integrative approach to combine publichealth and EM clinical topics during usual residency didactics, one partnered with local publichealth organizations to provide real-world experiences for residents, and one drew on existing national as well as departmental resources to seamlessly integrate more public health–oriented educational activities within the existing residency curriculum. The modular and integrative approaches appeared to have a positive impact on resident attitudes toward publichealth, and a majority of EM residents at that program believed publichealth training is important. Reliance on pre-existing community partnerships facilitated development of publichealth rotations for residents. External funding for these efforts was critical to their success, given the time and financial restraints on residency programs. The optimal approach for publichealth education for EM residents has not been defined. PMID:21961671

The environment continues to be a source of ill-health for many people, particularly in developing countries. International environmental law offers a viable strategy for enhancing publichealth through the promotion of increased awareness of the linkages between health and environment, mobilization of technical and financial resources, strengthening of research and monitoring, enforcement of health-related standards, and promotion of global cooperation. An enhanced capacity to utilize international environmental law could lead to significant worldwide gains in publichealth. PMID:12571726

, Georgia’s response to the Ebola crisis, palliative care, and essentials of advocacy in action for publichealth. Concurrent workshops focused on Board of Health training, publichealth accreditation, capacity building, collaboration, patient-centered outcomes, synthetic cannabinoid use, the HIV care continuum, use of data for informed decision making, environmental threats, organizational development, epidemiology, policy, and regulation. Thirty-two (32) awards were presented, including Lawmaker of the Year Award to Governor Nathan and First Lady Sandra Deal for their active and engaged role in promoting publichealth in Georgia; and the Sellers-McCroan Award to Commissioner Brenda Fitzgerald, Georgia Department of PublicHealth (DPH) State Health Officer, for her leadership of the Georgia Ebola Response Team and leadership of the newly formed department. The conference attracted 569 registrants primarily through pre-registration (n=561) with limited onsite registration (n=8). For this year’s conference, there was a significant increase in attendance (36%) and exhibitors (33%) relative to 2014. Of registrants reporting GPHA section participation, representation included: academic (5%); administration (10%); boards of health (13%); career development (15%); emergency preparedness (2%); epidemiology (5%); health education and promotion (2%); information technology (2%); maternal and child health (3%); medical/dental (3%); nursing (10%); nutrition (<1%); and other/no record (15%). There was 100% participation in the conference from the state’s 18 publichealth districts. The conference evaluation completed by a representative sample of registrants indicated areas of potential improvement as: starting sessions on time, using electronic and social media for the conference agenda/syllabus, and decreasing workshop sessions to 45 minutes. Most rated the conference as “good” or “excellent.” PMID:26835519

Background Global publichealth today faces new challenges and is impacted by a range of actors from within and outside state boundaries. The diversity of the actors involved has created challenges and a complex environment that requires a new context-tailored global approach. The World Federation of PublicHealth Associations has embarked on a collaborative consultation with the World Health Organization to encourage a debate on how to adapt publichealth to its future role in global health. Design A qualitative study was undertaken. High-level stakeholders from leading universities, multilateral organizations, and other institutions worldwide participated in the study. Inductive content analyses were performed. Results Stakeholders underscored that global publichealth today should tackle the political, commercial, economic, social, and environmental determinants of health and social inequalities. A multisectoral and holistic approach should be guaranteed, engaging publichealth in broad dialogues and a concerted decision-making process. The connection between neoliberal ideology and publichealth reforms should be taken into account. The WHO must show leadership and play a supervising and technical role. More and better data are required across many programmatic areas of publichealth. Resources should be allocated in a sustainable and accountable way. Publichealth professionals need new skills that should be provided by a collaborative global education system. A common framework context-tailored to influence governments has been evaluated as useful. Conclusions The study highlighted some of the main publichealth challenges currently under debate in the global arena, providing interesting ideas. A more inclusive integrated vision of global health in its complexity, shared and advocated for by all stakeholders involved in decision-making processes, is crucial. This vision represents the first step in innovating publichealth at the global level and should lead

Evaluating the potential health impacts of chemical, physical, and biological environmental factors represents a challenging task with profound medical, publichealth, and historical implications. The history of publichealth is replete with instances, ranging from tobacco to lead and asbestos, where the ability to obtain evidence on potential…

The Community Assessment Tool (CAT) for PublicHealth Emergencies Including Pandemic Influenza (hereafter referred to as the CAT) was developed as a result of feedback received from several communities. These communities participated in workshops focused on influenza pandemic planning and response. The 2008 through 2011 workshops were sponsored by the Centers for Disease Control and Prevention (CDC). Feedback during those workshops indicated the need for a tool that a community can use to assess its readiness for a disaster - readiness from a total healthcare perspective, not just hospitals, but the whole healthcare system. The CAT intends to do just that - help strengthen existing preparedness plans by allowing the healthcare system and other agencies to work together during an influenza pandemic. It helps reveal each core agency partners (sectors) capabilities and resources, and highlights cases of the same vendors being used for resource supplies (e.g., personal protective equipment [PPE] and oxygen) by the partners (e.g., publichealth departments, clinics, or hospitals). The CAT also addresses gaps in the community's capabilities or potential shortages in resources. This tool has been reviewed by a variety of key subject matter experts from federal, state, and local agencies and organizations. It also has been piloted with various communities that consist of different population sizes, to include large urban to small rural communities.

Reducing harm from drug use lies at the intersection of publichealth, public policy, politics and policing. In an ideal world, evidence of publichealth gains achievable through new approaches or technologies should inform public policy, should help shape political agendas in support of policy change, which should translate into law and regulations – and then to their application. The goal of this transformative process should be to yield the highest attainable health benefits to vulnerable individuals and communities and to society as a whole. PMID:22769027

Once viewed primarily as a criminal justice problem, violence and its prevention are now often claimed by publichealth professionals as being within their purview. The author reviewed 282 articles published in publichealth and medical journals from 1985 through 1995 that discussed violence as a publichealth problem. She found that while authors tended to identify social and structural causes for violence, they suggested interventions that targeted individuals' attitudes or behaviors and improved publichealth practice. Her study illuminates the tension between publichealth professionals' vision of the social precursors of violence and their attempts to apply a traditional set of remedies. In targeting individuals to rid the nation of violence, the publichealth community is deemphasizing societal causes. Images p[498]-a p499-a p500-a p501-a p502-a p503-a p504-a p506-a PMID:9847921

Pharmacogenomics are frequently considered in personalized medicine to maximize therapeutic benefits and minimize adverse drug reactions. However, there is a movement towards applying this technology to populations, which may produce the same benefits, while saving already scarce health resources. We conducted a narrative literature review to examine how pharmacogenomics and publichealth can constructively intersect, particularly in resource-poor settings. We identified 27 articles addressing the research question. Real and theoretical connections between publichealth and pharmacogenomics were presented in the areas of disease, drugs and public policy. Suggested points for consideration, such as educational efforts and cultural acceptability, were also provided. Including pharmacogenomics in publichealth can result in both health-related and economic benefits. Including pharmacogenomics in publichealth holds promise but deserves extensive consideration. To fully realize the benefits of this technology, support is needed from private, public and governmental sectors in order to ensure the appropriateness within a society. PMID:22594512

A robust health infrastructure in every country is the most effective long-term preparedness strategy for global health emergencies. This includes not only health systems and their human resources, but also countries' legal infrastructure for health: the laws and policies that empower, obligate and sometimes limit government and private action. The law is also an important tool in health promotion and protection. Publichealth professionals play important roles in health law - from the development of policies, through their enforcement, to the scientific evaluation of the health impact of laws. Member States are already mandated to communicate their national health laws and regulations to the World Health Organization (WHO). In this paper we propose that WHO has the authority and credibility to support capacity-building in the area of health law within Member States, and to make national laws easier to access, understand, monitor and evaluate. We believe a strong case can be made to donors for the funding of a publichealth law centre or unit, that has adequate staffing, is robustly networked with its regional counterparts and is integrated into the main work of WHO. The mission of the unit or centre would be to define and integrate scientific and legal expertise in publichealth law, both technical and programmatic, across the work of WHO, and to conduct and facilitate global health policy surveillance. PMID:27429492

Abstract A robust health infrastructure in every country is the most effective long-term preparedness strategy for global health emergencies. This includes not only health systems and their human resources, but also countries’ legal infrastructure for health: the laws and policies that empower, obligate and sometimes limit government and private action. The law is also an important tool in health promotion and protection. Publichealth professionals play important roles in health law – from the development of policies, through their enforcement, to the scientific evaluation of the health impact of laws. Member States are already mandated to communicate their national health laws and regulations to the World Health Organization (WHO). In this paper we propose that WHO has the authority and credibility to support capacity-building in the area of health law within Member States, and to make national laws easier to access, understand, monitor and evaluate. We believe a strong case can be made to donors for the funding of a publichealth law centre or unit, that has adequate staffing, is robustly networked with its regional counterparts and is integrated into the main work of WHO. The mission of the unit or centre would be to define and integrate scientific and legal expertise in publichealth law, both technical and programmatic, across the work of WHO, and to conduct and facilitate global health policy surveillance. PMID:27429492

Mass-gathering (MG) events pose challenges to the most adept of publichealth practitioners in ensuring the health safety of the population. These MGs can be for sporting events, musical festivals, or more commonly, have religious undertones. The Kumbh Mela 2013 at Allahabad, India may have been the largest gathering of humanity in history with nearly 120 million pilgrims having thronged the venue. The scale of the event posed a challenge to the maintenance of publichealth security and safety. A snapshot of the experience of managing the hygiene and sanitation aspects of this mega event is presented herein, highlighting the importance of proactive publichealth planning and preparedness. There having been no outbreaks of disease is vindication of the steps undertaken in planning and preparedness, notwithstanding obvious limitations of unsanitary behaviors and traditional beliefs of those attending the festival. The evident flaw on post-event analyses was the failure to cater adequately for environmental mopping-up operations after the festival. Besides, a system of real-time monitoring of disease and morbidity patterns, harnessing low cost technology alternatives, should be planned for at all such future events. PMID:26490181

We conducted a literature review in 2011 to determine if accepted governance functions continue to reflect the role of publichealth governing entities. Reviewing literature and other source documents, as well as consulting with practitioners, resulted in an iterative process that identified 6 functions of publichealth governance and established definitions for each of these: policy development; resource stewardship; continuous improvement; partner engagement; legal authority; and oversight of a health department. These functions provided context for the role of governing entities in publichealth practice and aligned well with existing publichealth accreditation standards. Publichealth systems research can build from this work in future explorations of the contributions of governance to health department performance. PMID:25689187

We conducted a literature review in 2011 to determine if accepted governance functions continue to reflect the role of publichealth governing entities. Reviewing literature and other source documents, as well as consulting with practitioners, resulted in an iterative process that identified 6 functions of publichealth governance and established definitions for each of these: policy development; resource stewardship; continuous improvement; partner engagement; legal authority; and oversight of a health department. These functions provided context for the role of governing entities in publichealth practice and aligned well with existing publichealth accreditation standards. Publichealth systems research can build from this work in future explorations of the contributions of governance to health department performance. PMID:25689187

Lithuania faces stark problems that are familiar to most countries in the former Soviet Union: high morbidity and mortality rates, pollution, an unstable economy, and rapid changes in the financing and organisation of health care. In this environment Moore and Dixon visited Kaunas Medical Academy to help identify how training in publichealth medicine could contribute towards improving the health of the population. Although over 200 hours are devoted to publichealth training for medical undergraduates, teaching is unfocused, fragmented, and includes little epidemiology--the core subject for publichealth physicians. Teaching is mainly through long lectures with few group discussions. Student participation and motivation are low. As well as recommending redesign of the curriculum, Moore and Dixon suggested training in teaching methods for teachers. They also suggested that postgraduate training in publichealth should begin and should be targeted at hospital managers, teaching staff, and existing publichealth physicians. Images p913-a PMID:8490421

The publichealth clinic under the jurisdiction of prefectural government should continue to play a major role in maternal-child health services. Ministry of Health's revision plan for Maternal-child Health Law, according to which maternal-child health services are to be transferred totally to municipal (city-town-village) government, is strongly opposed by publichealth nurses and others. The plan goes against the current movement and effort to revitalize publichealth clinics, where more 50% of services rendered are maternal-child health related. Secondly, municipal health centers would have much more difficulty providing quality services than prefectural publichealth clinics which receive annual federal aid for their operation. Federal funding for maternal-child health care, regardless of jurisdictions, is currently 1/3 of standard unit cost. Extreme financial strain on municipal governments would result in regional differences in the quality of services and/or eventual financial burden on the patients. While the national government is trying to emphasize administrative aspects of the publichealth clinic, it is ordinary citizens' day to day health problems that people expect the clinic to deal with, individually, via check-ups, health counseling, home visits, publichealth education and telephone health hot line. PMID:3642046

Knowing and applying the basic management functions of planning, organizing, staffing, directing, and controlling, as well as their permutations and combinations, are vital to effective delivery of publichealth services. Presently, graduate programs that prepare publichealth professionals neither emphasize teaching management theory, nor its application. This deficit puts those who become managers in publichealth and those they serve at a distinct disadvantage. This deficit can be remedied by enhanced teaching of management subjects PMID:26673475

Increased information availability, timeliness, and comprehensiveness through health information exchange (HIE) can support publichealth practice. The potential benefits to disease monitoring, disaster response, and other publichealth activities served as an important justification for the US’ investments in HIE. After several years of HIE implementation and funding, we sought to determine if any of the anticipated benefits of exchange participation were accruing to state and local publichealth practitioners participating in five different exchanges. Using qualitative interviews and template analyses, we identified publichealth efforts and activities that were improved by participation in HIE. HIE supported publichealth activities consistent with expectations in the literature. However, no single department realized all the potential benefits of HIE identified. These findings suggest ways to improve HIE usage in publichealth. PMID:25954386

Accurate information on how much the United States spends on publichealth is critical. These estimates affect planning efforts; reflect the value society places on the publichealth enterprise; and allows for the demonstration of cost-effectiveness of programs, policies, and services aimed at increasing population health. Yet, at present, there are a limited number of sources of systematic publichealth finance data. Each of these sources is collected in different ways, for different reasons, and so yields strikingly different results. This article aims to compare and contrast all 4 current national publichealth finance data sets, including data compiled by Trust for America's Health, the Association of State and Territorial Health Officials (ASTHO), the National Association of County and City Health Officials (NACCHO), and the Census, which underlie the oft-cited National Health Expenditure Account estimates of publichealth activity. In FY2008, ASTHO estimates that state health agencies spent $24 billion ($94 per capita on average, median $79), while the Census estimated all state governmental agencies including state health agencies spent $60 billion on publichealth ($200 per capita on average, median $166). Census publichealth data suggest that local governments spent an average of $87 per capita (median $57), whereas NACCHO estimates that reporting LHDs spent $64 per capita on average (median $36) in FY2008. We conclude that these estimates differ because the various organizations collect data using different means, data definitions, and inclusion/exclusion criteria--most notably around whether to include spending by all agencies versus a state/local health department, and whether behavioral health, disability, and some clinical care spending are included in estimates. Alongside deeper analysis of presently underutilized Census administrative data, we see harmonization efforts and the creation of a standardized expenditure reporting system as a way to

In an attempt to stimulate development of publichealth finance as a field of practice, policy, and scholarship, this article proposes a working definition of the term "publichealth finance," embeds it in the context of the maturing literature on the publichealth system and its infrastructure, and proposes a four-part typology that spans both public-sector and private-sector contributions to the financing of prevention and health promotion. A developmental strategy for the field--in applied research, training and education, and performance standards--is outlined as well. PMID:15552760

Ethical issues that can arise in distinguishing publichealth research from practice are highlighted in 2 case studies--an investigation of a tuberculosis outbreak in a prison and an evaluation of a program for improving HIV prevention services. Regardless of whether such publichealth investigations represent research or practice, we see a need for ethics oversight procedures that reflect actual risks and enable timely responses to crises. Such oversight should accommodate the perspectives of persons and communities affected by publichealth threats and by governmental responses to those threats; it should further recognize that publichealth ethics is a distinct field combining bioethics, political philosophy, human rights, and law. PMID:15249291

Brands build relationships between consumers and products, services, or lifestyles by providing beneficial exchanges and adding value to their objects. Brands can be measured through associations that consumers hold for products and services. Publichealth brands are the associations that individuals hold for health behaviors, or lifestyles that embody multiple health behaviors. We systematically reviewed the literature on publichealth brands; developed a methodology for describing branded health messages and campaigns; and examined specific branding strategies across a range of topic areas, campaigns, and global settings. We searched the literature for published studies on publichealth branding available through all relevant, major online publication databases. Publichealth branding was operationalized as any manuscripts in the health, social science, and business literature on branding or brands in health promotion marketing. We developed formalized decision rules and applied them in identifying articles for review. We initially identified 154 articles and reviewed a final set of 37, 10 from Africa, Australia, and Europe. Branded health campaigns spanned most of the major domains of publichealth and numerous communication strategies and evaluation methodologies. Most studies provided clear information on planning, development, and evaluation of the branding effort, while some provided minimal information. Branded health messages typically are theory based, and there is a body of evidence on their behavior change effectiveness, especially in nutrition, tobacco control, and HIV/AIDS. More rigorous research is needed, however, on how branded health messages impact specific populations and behaviors. PMID:19051110

In the ever-changing, resource-limited publichealth environment, the use of partners found in the faculty and students of Colleges of PublicHealth can provide training, consultation, and technical assistance needed to increase local health department (LHD) workforce capacity to meet new publichealth demands including national public heath accreditation. This manuscript describes the provision of the backbone support activities of facilitation, data management, and project management by University of Kentucky’s College of PublicHealth to Kentucky’s LHDs seeking national publichealth accreditation. PMID:25806362

Medical progress has enabled achievements that were not even thinkable earlier but at the same time society and publichealth have had to face new challenges. What are we ready to accept in the area of human reproduction? This paper aims at ethical analysis of Bulgarian laws on reproduction. The abortion debate nowadays has got new dimiension focusing not that much on its moral acceptability but rather on the acceptable indications for its performance. Is it ethical to perform abortion in case of undesired gender of the embryo or genetic malformations? Lots of moral issues mark the area of assisted reproduction which is due to the separation of the reproductive functions (ova, sperm and embryo donation, surrogacy), fragmentation of motherhood and fatherhood, differentiation of biological and social parenthood. Defining limits of acceptable interference or non-interference in human reproduction will never be easy, but dynamics of moral judgment shouldn't bother us. The rigidity of moral norms is what should be alarming because it threatens procreative autonomy. PMID:24919342

There is scientific consensus that the global climate is changing, with rising surface temperatures, melting ice and snow, rising sea levels, and increasing climate variability. These changes are expected to have substantial impacts on human health. There are known, effective publichealth responses for many of these impacts, but the scope, timeline, and complexity of climate change are unprecedented. We propose a publichealth approach to climate change, based on the essential publichealth services, that extends to both clinical and population health services and emphasizes the coordination of government agencies (federal, state, and local), academia, the private sector, and nongovernmental organizations. PMID:18235058

As part of their core mission, publichealth agencies attend to a wide range of disease and health threats, including those that require routine, acute, and emergency responses. While each incident is unique, the number and type of response activities are finite; therefore, through comparative analysis, we can learn about commonalities in the response patterns that could improve predictions and expectations regarding the resources and capabilities required to respond to future acute events. In this study, we interviewed representatives from more than 120 local health departments regarding their recent experiences with real-world acute publichealth incidents, such as infectious disease outbreaks, severe weather events, chemical spills, and bioterrorism threats. We collected highly structured data on key aspects of the incident and the publichealth response, particularly focusing on the publichealth activities initiated and community partners engaged in the response efforts. As a result, we are able to make comparisons across event types, create response profiles, and identify functional and structural response patterns that have import for future publichealthpreparedness and response. Our study contributes to clarifying the complexity of publichealth response systems and our analysis reveals the ways in which these systems are adaptive to the character of the threat, resulting in differential activation of functions and partners based on the type of incident. Continued and rigorous examination of the experiences of health departments throughout the nation will refine our very understanding of what the publichealth response system is, will enable the identification of organizational and event inputs to performance, and will allow for the construction of rich, relevant, and practical models of response operations that can be employed to strengthen publichealth systems. PMID:24236137

More than 100 years ago, publichealth began as an organized discipline, its purpose being to improve the health of populations rather than of individuals. Given its population-based focus, however, publichealth perennially faces dilemmas concerning the appropriate extent of its reach and whether its activities infringe on individual liberties in ethically troublesome ways. In this article a framework for ethics analysis of publichealth programs is proposed. To advance traditional publichealth goals while maximizing individual liberties and furthering social justice, publichealth interventions should reduce morbidity or mortality; data must substantiate that a program (or the series of programs of which a program is a part) will reduce morbidity or mortality; burdens of the program must be identified and minimized; the program must be implemented fairly and must, at times, minimize preexisting social injustices; and fair procedures must be used to determine which burdens are acceptable to a community. PMID:11684600

High-volume horizontal hydraulic fracturing (HVHF) in unconventional gas reserves has vastly increased the potential for domestic natural gas production. HVHF has been promoted as a way to decrease dependence on foreign energy sources, replace dirtier energy sources like coal, and generate economic development. At the same time, activities related to expanded HVHF pose potential risks including ground- and surface water contamination, climate change, air pollution, and effects on worker health. HVHF has been largely approached as an issue of energy economics and environmental regulation, but it also has significant implications for publichealth. We argue that publichealth provides an important perspective on policymaking in this arena. The American PublicHealth Association (APHA) recently adopted a policy position for involvement of publichealth professionals in this issue. Building on that foundation, this commentary lays out a set of five perspectives that guide how publichealth can contribute to this conversation. PMID:23552646

There is a well-known quotation by the nineteenth-century sociologist Virchow (quoted in Ref. 1) that aptly captures the dilemma that has confronted publichealth medicine since the specialty was created as a discrete entity in 1848. Virchow said: 'Medicine is politics and social medicine is politics writ large!' What does this mean in relation to effective publichealth medicine practice and how is it likely to affect its future? There is increasingly limited freedom of expression within the current context of political correctness, central control and a rapidly burgeoning litigious climate. The purpose of this paper is to explore these issues and to propose a means of maintaining publichealth medicine integrity within a working environment where action is becoming rapidly constrained by political rigidity. An additional factor to be included in the dialogue is the current context within which publichealth physicians work. Because the majority of publichealth doctors are employed within the National Health Service (NHS), they are finding themselves being expected to take on tasks and responsibilities marginal to their essential purpose and function. For example, publichealth physicians spend a great deal of time involved in detailed deliberations about health service provision. Although there is a great deal of evidence to show that good quality health care provision positively affects the health of the individual, there is no evidence to show that this activity has any effect on the population's health status. The essence of publichealth medicine practice is the prevention of ill-health and the promotion of the health of the population and, consequently, attention needs to be focused on the root causes of disease. However, as these are outside the aegis of the NHS, publichealth medicine involvement in such issues as education, nutrition, housing, transport and poverty is regarded as marginal to the NHS corporate agenda. PMID:11939386

Medical care applies to the individual, and publichealth to the community. One is the concentrated application of diagnosis and treatment for the life, the comfort of a patient, and includes guidance in health as for motherhood, infancy, childhood and old age. Publichealth services, provided by the community through its local government and the local department of health, are concerned with the prevention of diseases of all kinds. Some are controlled by sanitary authority, but the majority of preventable diseases are dealt with by publichealth education. It is not the function of the health department to treat the sick. The family physicians, the hospitals and dispensaries provide for medical care. Medical care of the sick and publichealth protection are two parallel activities to make use of medical science, one for treatment, the other for prevention of disease. PMID:13009462

This article describes a framework and empirical evidence to support the argument that educational programs and policies are crucial publichealth interventions. Concepts of education and health are developed and linked, and we review a wide range of empirical studies to clarify pathways of linkage and explore implications. Basic educational expertise and skills, including fundamental knowledge, reasoning ability, emotional self-regulation, and interactional abilities, are critical components of health. Moreover, education is a fundamental social determinant of health – an upstream cause of health. Programs that close gaps in educational outcomes between low-income or racial and ethnic minority populations and higher-income or majority populations are needed to promote health equity. Publichealth policy makers, health practitioners and educators, and departments of health and education can collaborate to implement educational programs and policies for which systematic evidence indicates clear publichealth benefits. PMID:25995305

Reducing racial disparities in postdisaster mental health requires the integration of unique and complex community challenges in disaster planning. We conducted focus group discussions with 13 community leaders and 7 clinical providers in eastern North Carolina to inform the adaptation of a competency-based training model in postdisaster mental health for black communities. The audience-specific perspectives on disaster mental health and training priorities were identified by structured thematic analyses. Community leaders and clinical providers without personal ties to the local black population were unaware of internal networks and other community resources. Conversely, most black community leaders and clinical providers were unaware of local disaster response resources. All participants identified training in coordination, outreach to reduce mental health stigma, and cultural competence as priority training needs. Black community leaders also were concerned about their inclusion in local planning and leveraging resources. These inputs and suggestions made for tailoring with culturally appropriate language and processes guided the development of learning objectives, content, and field testing of the feasibility of trainer the trainer delivery of postdisaster mental health training for clinical providers and community leaders serving vulnerable black populations. PMID:21999042

This article focuses on the redistributive effects of different measures to finance publichealth insurance. We analyse the implications of different financing options for publichealth insurance on the redistribution of income from good to bad health risks and from high-income to low-income individuals. The financing options considered are either income-related (namely income taxes, payroll taxes, and indirect taxes), health-related (co-insurance, deductibles, and no-claim), or neither (flat fee). We show that governments who treat access to health care as a basic right for everyone should consider redistributive effects when reforming health care financing. PMID:18347823

It is widely accepted that epidemiological data provide the only reliable evidence of a carcinogenic effect in humans, but epidemiology is unable to provide early warning of a cancer risk. The experimental approach to carcinogenicity can ascertain and predict potential cancer risks to humans in time for primary prevention to be successful. Unfortunately, only in rare instances were experimental data considered sufficiently convincing per se to stimulate the adoption of preventive measures. The experimental testing of environmental agents is the second line of defense against potential human carcinogens. The first line is the testing of synthesized agents, be these pesticides, medical drugs, or industrial chemical/physical agents, at the time of their development. We do not know, however, how many substances have been prevented from entering the environment because most tests are carried out by commercial or private laboratories and results are rarely released. A better understanding of the mechanisms underlying the sequence of events of the carcinogenesis process will eventually lead to a more accurate characterization and quantification of risks. However, the ways that mechanistic data have been used lately for evaluating evidence of carcinogenicity have not necessarily meant that the evaluations were more closely oriented toward publichealth. A tendency has surfaced to dismiss the relevance of long-term carcinogenicity studies. In the absence of absolute certainty, rarely if ever reached in biology, it is essential to adopt an attitude of responsible caution, in line with the principles of primary prevention, the only one that may prevent unlimited experimentation on the entire human species. PMID:12562637

The last 14 years has taught us that that we are facing a new reality; a reality in which publichealth emergencies are a common occurrence. Today, we live in a world with dangerous people without state sponsorship who are an enormous threat to our safety; one where emerging and reemerging infectious diseases are waiting to break out; a world where the benefits of globalization in trade, transportation, and social media brings threats to our communities faster and with a greater risk than ever before. Even climate change has entered into the preparedness equation, bringing with it the forces of nature in the form of extreme weather and its complications. PMID:26545197

A study was organized to orient the district level health sector disaster managers to review, revise and update the health sector contingency plan (HSCP) against common natural calamities, followed by its execution and evaluation. An inter-state 3 days workshop was organized at Kolkata during the month of October 2004 to review the district level HSCP and its execution in 5 (five) worst affected districts. The District Health Officers, in consultation with the investigators, revised and updated the HSCP. Thereafter, status survey was conducted to examine the implementation of the contingency plan. During flood, the HSCP was found to be followed in the districts. Control room, construction/identification of flood shelter, sanitation and other preventive measures were taken care of, with an exception of Kendra Para, where lack of man power was noted. Technical support, trained manpower, relief materials, ambulance, Communication and information system were present in all the 5 (five) districts. PMID:20108889

Recognition of petroleum as a finite global resource has spurred increasing interest in the intersection between petroleum scarcity and publichealth. Local health departments represent a critical yet highly vulnerable component of the publichealth infrastructure. These frontline agencies currently face daunting resource constraints and rely heavily on petroleum for vital population-based health services. Against this backdrop, petroleum scarcity may necessitate reconfiguring local publichealth service approaches. We describe the anticipated impacts of petroleum scarcity on local health departments, recommend the use of the 10 Essential PublicHealth Services as a framework for examining attendant operational challenges and potential responses to them, and describe approaches that local health departments and their stakeholders could consider as part of timely planning efforts. PMID:21778471

Poor housing conditions are associated with a wide range of health conditions, including respiratory infections, asthma, lead poisoning, injuries, and mental health. Addressing housing issues offers publichealth practitioners an opportunity to address an important social determinant of health. Publichealth has long been involved in housing issues. In the 19th century, health officials targeted poor sanitation, crowding, and inadequate ventilation to reduce infectious diseases as well as fire hazards to decrease injuries. Today, publichealth departments can employ multiple strategies to improve housing, such as developing and enforcing housing guidelines and codes, implementing “Healthy Homes” programs to improve indoor environmental quality, assessing housing conditions, and advocating for healthy, affordable housing. Now is the time for publichealth to create healthier homes by confronting substandard housing. PMID:11988443

More than 100 people gathered in Birmingham on April 23 for the third joint conference of the Veterinary PublicHealth Association and the Association of Government Vets. With the theme of 'VPH hands on - making a difference together', the meeting considered the role vets play in society through their work on publichealth and sustainability. Kathryn Clark reports. PMID:27288163

This curriculum guide serves to assist faculty who are developing undergraduate courses in publichealth as well as educational administrators and faculty curriculum committees who are designing undergraduate publichealth curricula. The approach outlined in these recommendations focuses on the development of three core courses, each of which is…

Human service fields, and more specifically publichealth, are increasingly requiring evaluations to prove the worth of funded programs. Many publichealth practitioners, however, lack the required background and skills to conduct useful, appropriate evaluations. In the late 1990s, the Centers for Disease Control and Prevention (CDC) created the…

The Association of State and Territorial PublicHealth Nutrition Directors (ASTPHND), with support from a cooperative agreement with the U.S. Department of Agriculture (USDA), conducted a census of the professional and paraprofessional publichealth nutrition workforce in the sta...

Physical inactivity is a serious publichealth problem that is associated with numerous preventable diseases. Publichealth concerns, particularly those related to the increased prevalence of overweight, obesity, and diabetes, call for schools to become proactive in the promotion of healthy, physically active lifestyles. This article begins by…

Despite the Canadian publichealth community's commitments to promoting public policy that supports health, evidence indicates that Canada's publichealth picture continues to decline. This may be due in part to the failure of publichealth agencies and local publichealth units to engage in public policy advocacy and public education about the social determinants of health. Examples of such activities by local publichealth units are now available and provide a model for such activity. PMID:23618021

Twenty-first-century trade policy is complex and affects society and population health in direct and indirect ways. Without doubt, trade policy influences the distribution of power, money, and resources between and within countries, which in turn affects the natural environment; people's daily living conditions; and the local availability, quality, affordability, and desirability of products (e.g., food, tobacco, alcohol, and health care); it also affects individuals' enjoyment of the highest attainable standard of health. In this article, we provide an overview of the modern global trade environment, illustrate the pathways between trade and health, and explore the emerging twenty-first-century trade policy landscape and its implications for health and health equity. We conclude with a call for more interdisciplinary research that embraces complexity theory and systems science as well as the political economy of health and that includes monitoring and evaluation of the impact of trade agreements on health. PMID:25494052

Context For three decades, experts have been stressing the importance of law to the effective operation of publichealth systems. Most recently, in a 2011 report, the Institute of Medicine recommended a review of state and local publichealth laws to ensure appropriate authority for publichealth agencies; adequate access to legal counsel for publichealth agencies; evaluations of the health effects and costs associated with legislation, regulations, and policies; and enhancement of research methods to assess the strength of evidence regarding the health effects of public policies. These recommendations, and the continued interest in law as a determinant of health system performance, speak to the need for integrating the emerging fields of PublicHealth Law Research (PHLR) and PublicHealth Systems and Services Research (PHSSR). Methods Expert commentary. Findings This article sets out a unified framework for the two fields and a shared research agenda built around three broad inquiries: (1) the structural role of law in shaping the organization, powers, prerogatives, duties, and limitations of publichealth agencies and thereby their functioning and ultimately their impact on publichealth (“infrastructure”); (2) the mechanisms through which publichealth system characteristics influence the implementation of interventional publichealth laws (“implementation”); and (3) the individual and system characteristics that influence the ability of publichealth systems and their community partners to develop and secure enactment of legal initiatives to advance publichealth (“innovation”). Research to date has laid a foundation of evidence, but progress requires better and more accessible data, a new generation of researchers comfortable in both law and health research, and more rigorous methods. Conclusions The routine integration of law as a salient factor in broader PHSSR studies of publichealth system functioning and health outcomes will enhance the

Background: For schools to be safe and supportive for students, school health professionals should be aware of the particular challenges lesbian, gay, bisexual, transgender, or questioning (LGBTQ) students face, especially the risk for discrimination, violent victimization, and depression in the school setting. We assessed school health…

Complex systems abound in publichealth. Complex systems are made up of heterogeneous elements that interact with one another, have emergent properties that are not explained by understanding the individual elements of the system, persist over time and adapt to changing circumstances. Publichealth is starting to use results from systems science studies to shape practice and policy, for example in preparing for global pandemics. However, systems science study designs and analytic methods remain underutilized and are not widely featured in publichealth curricula or training. In this review we present an argument for the utility of systems science methods in publichealth, introduce three important systems science methods (system dynamics, network analysis, and agent-based modeling), and provide three case studies where these methods have been used to answer important publichealth science questions in the areas of infectious disease, tobacco control, and obesity. PMID:22224885

Scientific and clinical activities undertaken by publichealth agencies may be misconstrued as medical research. Most discussions of regulatory and legal oversight of medical research focus on activities involving either patients in clinical practice or volunteers in clinical trials. These discussions often exclude similar activities that constitute or support core functions of publichealth practice. As a result, publichealth agencies and practitioners may be held to inappropriate regulatory standards regarding research. Through the lens of the Departments of Defense and Veterans Affairs, and using several case studies from these departments, we offer a framework for the adjudication of activities common to research and publichealth practice that could assist publichealth practitioners, research oversight authorities, and scientific journals in determining whether such activities require regulatory review and approval as research. PMID:24524499

Scientific and clinical activities undertaken by publichealth agencies may be misconstrued as medical research. Most discussions of regulatory and legal oversight of medical research focus on activities involving either patients in clinical practice or volunteers in clinical trials. These discussions often exclude similar activities that constitute or support core functions of publichealth practice. As a result, publichealth agencies and practitioners may be held to inappropriate regulatory standards regarding research. Through the lens of the Departments of Defense and Veterans Affairs, and using several case studies from these departments, we offer a framework for the adjudication of activities common to research and publichealth practice that could assist publichealth practitioners, research oversight authorities, and scientific journals in determining whether such activities require regulatory review and approval as research. PMID:24524499

Homicide is seven times as common among U.S. non-Hispanic Black as among non-Hispanic White youth ages 15 to 24 years. In 83% of these youth homicides, the murder weapon is a firearm. Yet, for more than a decade, the national publichealth position on youth violence has been largely silent about the role of firearms, and tools used by publichealth professionals to reduce harm from other potential hazards have been unusable where guns are concerned. This deprives already underserved populations from the full benefits publichealth agencies might be able to deliver. In part, political prohibitions against research about direct measures of firearm control and the absence of valid publichealth surveillance are responsible. More refined epidemiologic theories as well as traditional publichealth methods are needed if the U.S. aims to reduce disparate Black-White youth homicide rates. PMID:22643459

The publichealth and the public education systems in the United States have encountered problems in quality of service, accountability, and availability of resources. Both systems are under pressure to adopt the general organizational reform of privatization. The debate over privatization in public education is contentious, but in publichealth, the shift of functions from the public to the private sector has been accepted with limited deliberation. We assess the benefits and concerns of privatization and suggest that shifting publichealth functions to the private sector raises questions about the values and mission of publichealth. Publichealth officials need to be more engaged in a public debate over the desirability of privatization as the future of publichealth. PMID:17008563

Objectives. We sought to determine natural disaster preparedness levels among older US adults and assess factors that may adversely affect health and safety during such incidents. Methods. We sampled adults aged 50 years or older (n = 1304) from the 2010 interview survey of the Health and Retirement Study. The survey gathered data on general demographic characteristics, disability status or functional limitations, and preparedness-related factors and behaviors. We calculated a general disaster preparedness score by using individual indicators to assess overall preparedness. Results. Participant (n = 1304) mean age was 70 years (SD = 9.3). Only 34.3% reported participating in an educational program or reading materials about disaster preparation. Nearly 15% reported using electrically powered medical devices that might be at risk in a power outage. The preparedness score indicated that increasing age, physical disability, and lower educational attainment and income were independently and significantly associated with worse overall preparedness. Conclusions. Despite both greater vulnerability to disasters and continuous growth in the number of older US adults, many of the substantial problems discovered are remediable and require attention in the clinical, publichealth, and emergency management sectors of society. PMID:26313052

Objectives. We sought to determine natural disaster preparedness levels among older US adults and assess factors that may adversely affect health and safety during such incidents. Methods. We sampled adults aged 50 years or older (n = 1304) from the 2010 interview survey of the Health and Retirement Study. The survey gathered data on general demographic characteristics, disability status or functional limitations, and preparedness-related factors and behaviors. We calculated a general disaster preparedness score by using individual indicators to assess overall preparedness. Results. Participant (n = 1304) mean age was 70 years (SD = 9.3). Only 34.3% reported participating in an educational program or reading materials about disaster preparation. Nearly 15% reported using electrically powered medical devices that might be at risk in a power outage. The preparedness score indicated that increasing age, physical disability, and lower educational attainment and income were independently and significantly associated with worse overall preparedness. Conclusions. Despite both greater vulnerability to disasters and continuous growth in the number of older US adults, many of the substantial problems discovered are remediable and require attention in the clinical, publichealth, and emergency management sectors of society. PMID:24432877

General moral (ethical) principles play a prominent role in certain methods of moral reasoning and ethical decision-making in bioethics and publichealth. Examples include the principles of respect for autonomy, beneficence, nonmaleficence, and justice. Some accounts of ethics in publichealth have pointed to additional principles related to social and environmental concerns, such as the precautionary principle and principles of solidarity or social cohesion. This article provides an overview of principle-based methods of moral reasoning as they apply to publichealth ethics including a summary of advantages and disadvantages of methods of moral reasoning that rely upon general principles of moral reasoning. Drawing upon the literature on publichealth ethics, examples are provided of additional principles, obligations, and rules that may be useful for analyzing complex ethical issues in publichealth. A framework is outlined that takes into consideration the interplay of ethical principles and rules at individual, community, national, and global levels. Concepts such as the precautionary principle and solidarity are shown to be useful to publichealth ethics to the extent that they can be shown to provide worthwhile guidance and information above and beyond principles of beneficence, nonmaleficence, and justice, and the clusters of rules and maxims that are linked to these moral principles. Future directions likely to be productive include further work on areas of publichealth ethics such as public trust, community empowerment, the rights of individuals who are targeted (or not targeted) by publichealth interventions, individual and community resilience and wellbeing, and further clarification of principles, obligations, and rules in publichealth disciplines such as environmental science, prevention and control of chronic and infectious diseases, genomics, and global health. PMID:20072707

Publichealth agencies increasingly use electronic means to acquire, use, maintain, and store personal health information. Electronic data formats can improve performance of core publichealth functions, but potentially threaten privacy because they can be easily duplicated and transmitted to unauthorized people. Although such security breaches do occur, electronic data can be better secured than paper records, because authentication, authorization, auditing, and accountability can be facilitated. Publichealth professionals should collaborate with law and information technology colleagues to assess possible threats, implement updated policies, train staff, and develop preventive engineering measures to protect information. Tightened physical and electronic controls can prevent misuse of data, minimize the risk of security breaches, and help maintain the reputation and integrity of publichealth agencies. PMID:18382010

Publichealth personnel are the first-line workers of preventive care and medical services. In the face of rapid social and demographic changes, empowerment and on-job training have become important approaches to enhance the function of nurses. Health centers act like the "peripheral nerves" of the government healthcare system, as they must both reflect the needs of community residents and fully implement government mandated services. While widely distributed, health centers face manpower shortages and disorderly information collection and distribution systems. Empowerment and on-job training programs can enhance public heath staff knowledge in order to cope with heavy workloads and shift toward multi-dimensional development. This paper examines the experience of the New Taipei City PublicHealth Bureau in conducting health center empowerment programs from four perspectives, including personal cultivation and organizational cultivation. It was found that publichealth staff self-recognition of professional values can also be further strengthened through alliances within the community, and that establishing personal relationships with patients by "treating patients as relatives" was effective in realizing health center objectives. This paper also reminds agency supervisors that staff training is a critical management task. Health authorities should thus introduce in a timely manner organizational management, on-job training, service reengineering, and other related corporate philosophies; facilitate staff empowerment; consolidate core professional knowledge; and construct intellectual and social capital that meets health unit needs in order to enhance health center competitiveness and publichealth staff knowledge. PMID:21328202

Publichealth agencies face old and new problems in the next century: emerging infectious and chronic diseases, health problems related to personal behaviors, a changing demography, and a deteriorating physical and social environment. To meet these challenges, publichealth agencies should consider the following: the advent of new communications technologies, the need for a strong workforce, and the need for new partnerships. Distance learning can serve as a means to facilitate a strong workforce and new partnerships. PMID:10187065

Information science and technology are critical to the modern practice of publichealth. Yet today's publichealth professionals generally have no formal training in publichealth informatics--the application of information science and technology to publichealth practice and research. Responding to this need, the U.S. Centers for Disease Control and Prevention (CDC) recently developed, tested, and delivered a new training course in publichealth informatics. The course was designed for experienced publichealth program managers and included sessions on general informatics principles and concepts; key information systems issues and information technologies; and management issues as they relate to information technology projects. This course has been enthusiastically received both at the state and federal levels. We plan to develop an abbreviated version for health officers, administrators, and other publichealth executives. PMID:9929264

Internet access and use of georeferenced publichealth information for GIS application will be an important and exciting development for the nation's Department of Health and Human Services and other health agencies in this new millennium. Technological progress toward publichealth geospatial data integration, analysis, and visualization of space-time events using the Web portends eventual robust use of GIS by publichealth and other sectors of the economy. Increasing Web resources from distributed spatial data portals and global geospatial libraries, and a growing suite of Web integration tools, will provide new opportunities to advance disease surveillance, control, and prevention, and insure public access and community empowerment in publichealth decision making. Emerging supercomputing, data mining, compression, and transmission technologies will play increasingly critical roles in national emergency, catastrophic planning and response, and risk management. Web-enabled publichealth GIS will be guided by Federal Geographic Data Committee spatial metadata, OpenGIS Web interoperability, and GML/XML geospatial Web content standards. Publichealth will become a responsive and integral part of the National Spatial Data Infrastructure. PMID:12543872

During and after disasters, focus is directed toward meeting the immediate needs of the general population. As a result, the routine health care and the special needs of some vulnerable populations such as pregnant and postpartum women may be overlooked within a resource-limited setting. In the event of hazards such as natural disasters, manmade disasters, and terrorism, knowledge of emergency preparedness strategies is imperative for the pregnant woman and her family, obstetric providers, and hospitals. Individualized plans for the pregnant woman and her family should include knowledge of shelter in place, birth at home, and evacuation. Obstetric providers need to have a personal disaster plan in place that accounts for work responsibilities in case of an emergency and business continuity strategies to continue to provide care to their communities. Hospitals should have a comprehensive emergency preparedness program utilizing an "all hazards" approach to meet the needs of pregnant and postpartum women and other vulnerable populations during disasters. With lessons learned in recent tragedies such as Hurricane Katrina in mind, we hope this review will stimulate emergency preparedness discussions and actions among obstetric providers and attenuate adverse outcomes related to catastrophes in the future. PMID:25751222

Canton Hospital was not only the most influential missionary hospital in South China, but also the first one brought the concept and practice of publichealth to Guangzhou. In the late Qing Dynasty, it conducted free vaccination, plague treatment, health education and so on, demonstrating the importance of publichealth to the people. In the period of the Republic of China, it extensively cooperated with the government and social organizations in developing school health, maternal and child health, communicable disease control and epidemiological investigations to actively serve the social group. In the 1930s, its publichealth activities extended towards the rural areas of Guangzhou, and promoted the convergence of rural and urban medical and health services. The three-level medical system that it built provided demonstration model for the establishment of Chinese rural medical system. PMID:26815022

Community health educators are well versed in the behavior sciences, including intervention theories. However, most publichealth professionals are not familiar with the policy theories related to political advocacy. Because health educators are engaging in policy advocacy more frequently, and as a result of the profession including policy…

This paper discusses publichealth services of the Secretariat of the Pacific Community (SPC). The paper provides an overview of SPC and the Pacific Islands, including geography, nationality/culture, and development status. SPC Community Health Programmes (CHP) in the following areas are then described: environmental health; AIDS and STD (sexually…

This study builds on recent work describing African Americans' low trust in publichealth regarding terrorism preparedness by identifying the specific components of trust (fiduciary responsibility, honesty, competency, consistency, faith) that may influence community response to a bioterrorist attack. We used qualitative analysis of data from 75 African American adults living in Los Angeles County who participated in focus group discussions. Groups were stratified by socioeconomic status (SES; up to vs. above 200% of federal poverty guidelines) and age (18-39 years old vs. 40-65 years old). Discussions elicited reactions to information presented in escalating stages of a bioterrorism scenario. The scenario mimicked the events and publichealth decisions that might occur under such a scenario. Honesty and consistency of information from publichealth officials were the components most frequently identified as determining trust or distrust. Patterns of trust varied according to the scenario stage; honesty was most important upon initially hearing of a publichealth crisis, whereas fiduciary responsibility and consistency were important upon confirmation of a smallpox outbreak and the ensuing publichealth response. Findings can help publichealth officials design communications that address distrust and enhance trust during a bioterrorist event. PMID:17497377

Background The Third UN World Conference on Disaster Risk Reduction recommended the implementation of the Sendai Framework for Disaster Risk Reduction 2015–2030, which aims to achieve substantial risk reduction and to avoid various disaster-associated losses, including human lives and livelihoods, based on the lessons from the implementation of the Hyogo framework. However, the recommendations did not lay enough stress on the school and the Safe School Concept, which are the core components of a disaster response. Objective To raise the issue of the importance of schools in disaster response. Results For human capacity building to avoid the damage caused by natural disasters, we should focus on the function of schools in the community and on school health framework. Schools perform a range of functions, which include being a landmark place for evacuation, acting as a participatory education hub among communities (students are usually from the surrounding communities), and being a sustainable source of current disaster-related information. In 2007, the Bangkok Action Agenda (BAA) on school education and disaster risk reduction (DRR) recommended the integration of DRR into education policy development, the enhancement of participatory mechanisms to improve DRR education, and the extension of DRR education from schools to communities. Based on our discussion and the recommendations of the BAA, we suggest that our existing challenges are to construct a repository of disaster-related lessons, develop training materials based on current information drawn from previous disasters, and disseminate the training to schools and communities. Conclusions Schools linked with school health can provide good opportunities for DRR with a focus on development of school health policy and a community-oriented participatory approach. PMID:26689458

Background: The 5As approach is a clinic-based approach and has been developed for primary health care providers who are uniquely positioned to interact with tobacco users. The 5As stands for: Ask about tobacco use at every visit, advise tobacco users to quit, assess readiness to quit, assist quit attempts through counseling and pharmacotherapy and arrange follow-up to prevent relapse. The present study explores whether auxiliary nurse midwives (ANMs) adhere to the 3As from the recommended 5As model for tobacco cessation. Materials and Methods: The study was a cross-sectional study conducted among 501 ANMs in the state of Gujarat and Andhra Pradesh. Descriptive analysis and chi-square test were employed to test the differences in knowledge levels and practices of ANMs. Bivariate logistic regression was used to examine the association between each predictor variable separately and the outcome variables after adjusting for age and location. Data was analyzed using SPSS version 17 software. Results: Majority of ANMs reported that they were aware of respiratory illnesses, tuberculosis, lung and oral cancer as conditions caused due to tobacco consumption. Awareness of adverse reproductive and child health effects associated with tobacco use was very low. Only about one third of respondents informed all patients about harmful effects. Only 16% of ANMs reported having ever received any on-job training related to tobacco control. ANMs who reported receiving training in tobacco control were about two times more likely to provide information on health effects of tobacco as compared to those who reported not being trained in tobacco control in the state of Gujarat. Conclusions: A majority of ANMs ask patients about tobacco use but provide advice only to patients suffering from specific diseases. A context-specific capacity building package needs to be designed to equip ANMs in recommended 5As approach in tobacco cessation. PMID:26288762

This article describes how the CS2day (Cease Smoking Today) initiative positioned continuing education (CE) in the intersection between medicine and publichealth. The authors suggest that most CE activities address the medical challenges that clinicians confront, often to the neglect of the publichealth issues that are key risk factors for the…

Context: Today's societies have far-reaching impacts on future conditions for health. Against this backdrop, this article explores how the future is represented in contemporary publichealth, examining both its conceptual base and influential approaches through which evidence is generated for policy. Methods: Mission statements and official reviews provide insight into how the future is represented in publichealth's conceptual and ethical foundations. For its research practices, the article takes examples from epidemiological, intervention, and economic research, selecting risk-factor epidemiology, randomized controlled trials, and economic evaluation as exemplars. Findings: Concepts and ethics suggest that publichealth research and policy will be concerned with protecting both today's and tomorrow's populations from conditions that threaten their health. But rather than facilitating sustained engagement with future conditions and future health, exemplary approaches to gathering evidence focus on today's population. Thus, risk-factor epidemiology pinpoints risks in temporal proximity to the individual; controlled trials track short-term effects of interventions on the participants’ health; and economic evaluations weigh policies according to their value to the current population. While their orientation to the present and near future aligns well with the compressed timescales for policy delivery on which democratic governments tend to work, it makes it difficult for the publichealth community to direct attention to conditions for future health. Conclusions: This article points to the need for research perspectives and practices that, consistent with publichealth's conceptual and ethical foundations, represent the interests of both tomorrow's and today's populations. PMID:20579281

As we enter the 21st century the threats of biological warfare and bioterrorism (so called asymmetric threats) appear to be more real than ever before. Historical evidence suggests that biological weapons have been used, with varying degrees of success, for many centuries. Despite the international agreements to ban such weapons, namely the 1925 Geneva Protocol and the 1975 Biological and Toxin Weapons Convention, there is no effective international mechanism for challenging either the development of biological weapons or their use. Advances in technology and the rise of fundamentalist terror groups combine to present a significant threat to western democracies. A timely and definitive response to this threat will require co-operation between governments on a scale never seen before. There is a need for proper planning, good communication between various health, home office, defence and intelligence agencies and sufficient financial support for a realistic state of preparedness. The Department of Health has produced guidelines for responding to real or suspected incidents and the PublicHealth Laboratory Service (PHLS) has produced detailed protocols to inform the actions required by microbiologists and consultants in communicable disease control. These protocols will be published on the Department of Health and PHLS web sites. PMID:11676515

"Correctional Health Care: Implications for PublicHealth Policy" is the first in a series of articles that examines the special health care needs of persons who are incarcerated in America's correctional facilities. The intent of the series is to gain a better understanding about the unmet health needs of incarcerated persons, the importance of addressing the health service delivery system in correctional facilities, and the implications that may arise from neglecting to address these health issues on health outcomes for individual detainees and society at-large when detainees transition back into the community. This article provides a descriptive overview of the corrections population, their sociodemographics, health care needs, and health concerns that are in need of improvement. This article also offers recommendations for public policy consideration to improve the overall health of inmates and society at large. PMID:12069208

Reviews what current research says about the holistic health benefits of park and recreation services, focusing on: health benefits according to park users; physical activities in parks; stress reduction benefits of park use; social support, self-determination, and stress reduction; observing nature in parks and associated benefits; and the…

The Institute of Medicine concluded that keeping the public healthy required a well-educated publichealth workforce, thus leading to its recommendation that "all undergraduates should have access to education in publichealth" [2]. In response to this call, the authors examined the current practice, feasibility, and value in strengthening (or building) a functional collaborative model between academic institutions and practitioners from local health departments to educate tomorrow's publichealth workforce. Local and regional health departments in New England were surveyed to: (1) establish a baseline of existing working relationships between them and nearby academic institutions; (2) examine the barriers that inhibit the development of collaborations with academic partners; (3) assess how they jointly promote publichealth workforce development; and (4) analyze which essential publichealth services their partnership addresses. Despite the lack of financial resources often cited for the absence of academic-local health department collaborations, some New England states reported that their academic institution and local publichealth department partnerships were valued and productive. The authors discuss how effective academic-community collaborations have the potential to facilitate a broad-based appreciation of publichealth among students via a wide array of publichealth curricula and applied experiential learning opportunities in publichealth settings. The authors propose a model for how to combine basic publichealth lessons with practical experience and leadership offered by local health departments, in order to foster a real understanding of publichealth, its importance, practice, and relevance in today's society from a publichealth workforce perspective. PMID:22940868

An unprecedented number of Americans have been incarcerated in the past generation. In addition, arrests are concentrated in low-income, predominantly nonwhite communities where people are more likely to be medically underserved. As a result, rates of physical and mental illnesses are far higher among prison and jail inmates than among the general public. We review the health profiles of the incarcerated; health care in correctional facilities; and incarceration’s repercussions for publichealth in the communities to which inmates return upon release. The review concludes with recommendations that publichealth and medical practitioners capitalize on the publichealth opportunities provided by correctional settings to reach medically underserved communities, while simultaneously advocating for fundamental system change to reduce unnecessary incarceration. PMID:22224880

One widely held view of prenatal screening (PNS) is that its foremost aim is, or should be, to enable reproductive choice; this is the Pure Choice view. The article critiques this position by comparing it with an alternative: PublicHealth Pluralism. It is argued that there are good reasons to prefer the latter, including the following. (1) PublicHealth Pluralism does not, as is often supposed, render PNS more vulnerable to eugenics-objections. (2) The Pure Choice view, if followed through to its logical conclusions, may have unpalatable implications, such as extending choice well beyond health screening. (3) Any sensible version of PublicHealth Pluralism will be capable of taking on board the moral seriousness of abortion and will advocate, where practicable, alternative means of reducing the prevalence of disease and disability. (4) PublicHealth Pluralism is at least as well-equipped as the Pure Choice model to deal with autonomy and consent issues. PMID:25521971

One widely held view of prenatal screening (PNS) is that its foremost aim is, or should be, to enable reproductive choice; this is the Pure Choice view. The article critiques this position by comparing it with an alternative: PublicHealth Pluralism. It is argued that there are good reasons to prefer the latter, including the following. (1) PublicHealth Pluralism does not, as is often supposed, render PNS more vulnerable to eugenics-objections. (2) The Pure Choice view, if followed through to its logical conclusions, may have unpalatable implications, such as extending choice well beyond health screening. (3) Any sensible version of PublicHealth Pluralism will be capable of taking on board the moral seriousness of abortion and will advocate, where practicable, alternative means of reducing the prevalence of disease and disability. (4) PublicHealth Pluralism is at least as well-equipped as the Pure Choice model to deal with autonomy and consent issues. PMID:25521971

Public–private partnerships have become a common approach to health care problems worldwide. Many public–private partnerships were created during the late 1990s, but most were focused on specific diseases such as HIV/AIDS, tuberculosis, and malaria. Recently there has been enthusiasm for using public–private partnerships to improve the delivery of health and welfare services for a wider range of health problems, especially in developing countries. The success of public–private partnerships in this context appears to be mixed, and few data are available to evaluate their effectiveness. This analysis provides an overview of the history of health-related public–private partnerships during the past 20 years and describes a research protocol commissioned by the World Health Organization to evaluate the effectiveness of public–private partnerships in a research context. PMID:17138922

Objective To examine if a minimum efficient scale (MES) holds with respect to the population serviced by a local health department (LHD) given the congestability, externality, and scale/scope economy effects potentially associated with publichealth services. Data Sources/Study Setting A nationally representative sample of LHDs in 2005. Study Design Multiple regression analysis is used to isolate the relation between population and spending while controlling for other factors known to influence local publichealth costs. Data Collection Data were obtained from the 2005 National Profile of Local PublicHealth Agencies, a project supported through a cooperative agreement between the National Association of County and City Health Officials and the Centers for Disease Control and Prevention. Principal Findings The MES of a local publichealth department is approximately 100,000 people. After that size, additional population has little impact on publichealth spending per capita. Conclusions Seventy-seven percent of LHDs in the sample fall below the 100,000 MES. Higher levels of government may want to provide financial inducements so that smaller LHDs consolidate or enter into agreements with larger publichealth organizations to provide services. PMID:19656226

Applications of networking to health care have focused on the potential of networking to transmit data and to reduce the cost of health care. In the early 198Os networks began forming among academic institutions; one of them was Bitnet. During the 1980s Internet evolved, which joined diverse networks, including those of governments and industry. The first step is to connect publichealth organizations such as ministries of health, the World Health Organization, the Pan-American Health Organization, and the United Nations. Computer-based telecommunication will vastly increase effective transmission of information. Networking publichealth workers in local health departments, academia, governments, industry, and private agencies, will bring great benefits. One is global disease telemonitoring: with new epidemiological techniques such as capture-recapture, accurate estimates of incidences of important communicable and non-communicable diseases can now be obtained. Currently all countries in the Americas except Haiti are connected through Internet. No systematic integration of telecommunication and publichealth systems across countries has occurred yet. On-line vital statistics could be usable almost instantaneously to facilitate monitoring and forecasting of population growth and the health needs of mothers and children. Linking global disease telemonitoring (morbidity data for non-communicable diseases) with environmental data systems would considerably improve understanding of the environmental determinants of disease. Internet is already linked to the National Library of Medicine through Bitnis. Computer based distance education is rapidly improving through E-mail searches. Reading materials, video, pictures, and sound could be transmitted across huge distances for low costs. Hundreds of schools are already networked together. On-line electronic journals and books have the potential for instantaneous dissemination of free information through gopher servers. Global

This paper addresses the challenges faced in mainstreaming the teaching of sexual and reproductive health and rights into publichealth education. For this paper, we define sexual and reproductive health and rights education as including not only its biomedical aspects but also an understanding of its history, values and politics, grounded in gender politics and social justice, addressing sexuality, and placed within a broader context of health systems and global health. Using a case study approach with an opportunistically selected sample of schools of publichealth within our regional contexts, we examine the status of sexual and reproductive health and rights education and some of the drivers and obstacles to the development and delivery of sexual and reproductive health and rights curricula. Despite diverse national and institutional contexts, there are many commonalities. Teaching of sexual and reproductive health and rights is not fully integrated into core curricula. Existing initiatives rely on personal faculty interest or short-term courses, neither of which are truly sustainable or replicable. We call for a multidisciplinary and more comprehensive integration of sexual and reproductive health and rights in publichealth education. The education of tomorrow's publichealth leaders is critical, and a strategy is needed to ensure that they understand and are prepared to engage with the range of sexual and reproductive health and rights issues within their historical and political contexts. PMID:22118142

The relationship between insurance and publichealth is an enduring topic in publichealth policy and practice. Insurers share certain attributes with publichealth. But publichealth agencies operate in relation to the entire community that they are empowered by public law to serve and without regard to the insurance status of community residents; on the other hand, insurers (whether managed care or otherwise) are risk-bearing entities whose obligations are contractually defined and limited to enrolled members and sponsors. Public insurers such as Medicare and Medicaid operate under similar constraints. The fundamental characteristics that distinguish managed care-style insurance and publichealth become particularly evident during periods of publichealth emergency, when a publichealth agency's basic obligations to act with speed and flexibility may come face to face with the constraints on available financing that are inherent in the structure of insurance. Because more than 70% of all personal health care in the United States is financed through insurance, publichealth agencies effectively depend on insurers to finance necessary care and provide essential patient-level data to the publichealth system. Critical issues of state and federal policy arise in the context of the publichealth/insurance relations during publichealth emergencies. These issues focus on coverage and the power to make coverage decisions, as well as the power to define service networks and classify certain data as exempt from public reporting. The extent to which a formal regulatory approach may become necessary is significantly affected by the extent to which private entities themselves respond to the problem with active efforts to redesign their services and operations to include capabilities and accountability in the realm of publichealth emergency response. PMID:12508505

Publichealth surveillance is the ongoing, systematic collection, analysis, interpretation, and dissemination of data regarding a health-related event for use in publichealth action to reduce morbidity and mortality and to improve health by effective response management and coordination. As new pressures for early detection of disease outbreaks have arisen, particularly for outbreaks of possible bioterrorism (BT) origin, and as electronic health data have become increasingly available, so has the demand for publichealth situation awareness systems. Although these systems are valuable for early warning of publichealth emergencies, there remains the cost of developing and managing such large and complex systems and of investigating inevitable false alarms. Whether these systems are dependable and cost effective enough and can demonstrate a significant and indispensable role in detection or prevention of mass casualty events of BT origin remains to be proven. This article will focus on the complexities of design, analysis, implementation and evaluation of publichealth surveillance and situation awareness systems and, in some cases, will discuss the key technologies being studied in Center for Biosecurity Informatics Research at University of Texas, Health Science Center at Houston.

This paper, the first ever to review and critique publichealth developments in Kazakhstan, suggests ways in which publichealth can be improved strategically. The paper outlines the main threats to health in a dynamic economically developing country, but argues that with a health care reform agenda in place, and the Governments apparent support of publichealth policy initiatives, the time is right for new opportunities in the promotion of health. The paper utilises the Ottawa Charter, but suggests novel, more appropriate headings for Kazakhstan, to galvanise policy makers and professionals into tackling the growing burden of disease. It concludes by calling for greater transparency in relation to Government policy initiatives, and the need for greater national and international collaboration. PMID:17294711

Crime is a publichealth issue. It shares common causes with ill health, particularly poverty, and fear of violent crime is itself a major cause of anxiety. Community development in pre-school education, parental education, and among ethnic minorities, both reduces crime and promotes better health, for example in reducing the effects of alcohol and illicit drugs. Health workers should contribute in full to community development. PMID:9532958

The largest outbreak of Ebola virus disease occurred in West Africa in 2014 and resulted in unprecedented transmission even in distant countries. In Japan, only nine individuals were screened for Ebola and there was no confirmed case. However, the government promoted the reinforcement of response measures and interagency collaboration, with training and simulation exercises conducted country-wide. The legacies included: publication of a communication policy on case disclosure, a protocol for collaboration between publichealth and other agencies, and establishing an expert committee to assemble the limited available expertise. There were challenges in taking proportionate and flexible measures in the management of people identified to be at high risk at entry points to Japan, in the decentralised medical response strategy, and in the medical countermeasures preparedness. The Ebola outbreak in West Africa provided a crucial opportunity to reveal the challenges and improve the preparedness for rare but high impact emerging diseases that are prone to be neglected. Efforts to uphold the lessons learnt and maintain publichealthpreparedness should help prepare for future emerging diseases, including bioterrorist acts and pandemics. PMID:26559148

Emergency response for a transportation accident involving radiological materials, while not inherently difficult, presents a challenge for several reasons. These accidents, although they can occur anywhere, are rare. Also, although the health consequences are usually slight, accidents involving radioactive materials generally cause a great deal of concern, both for the emergency responders and the general public. How can communities be prepared for an event that requires some technical knowledge, but is so rare that it will never occur in most areas, without expending an effort disproportionate to the actual risk? How can one appropriately deal with an event that may cause excessive public concern? These questions are at the heart of the preparedness issues this program addressed. The overall goal of the Transportation Emergency Preparedness Program was to establish the framework for a coordinated response by all levels of government to a transportation accident involving radioactive material. The Program involved both preparedness activities and the development, conduct and evaluation of a field exercise in Saratoga County, New York. This Report concentrates on the functional activities, lessons learned, recommendations, and action plans for improving preparedness and response to a transportation accident involving radioactive materials.

The Oregon PublicHealth Policy Institute (PHPI) was designed to enhance publichealth policy competencies among state and local health department staff. The Oregon Health Authority funded the College of PublicHealth and Human Sciences at Oregon State University to develop the PHPI curriculum in 2012 and offer it to participants from 4 state publichealth programs and 5 local health departments in 2013. The curriculum interspersed short instructional sessions on policy development, implementation, and evaluation with longer hands-on team exercises in which participants applied these skills to policy topics their teams had selected. Panel discussions provided insights from legislators and senior Oregon health experts. Participants reported statistically significant increases in publichealth policy competencies and high satisfaction with PHPI overall. PMID:26066925

In January 1984, the Asia-Pacific Academic Consortium for PublicHealth (APACPH) was established, bringing together 5 schools of publichealth with the objectives: to raise the quality of professional education in publichealth; to enhance the knowledge and skills of health workers through joint projects; to solve health problems through closer links with each other and with ministries of health; to increase opportunities for graduate students through curriculum development; and to make child survival a major priority. The Consortium now comprises 31 academic institutions or units in 16 countries, and is supported by UNICEF, The World Health Organization, the China Medical Board of New York, and the governments of Japan and Malaysia. During 1985-1992, it also received major support from the United States through the US Agency for International Development and the University of Hawaii. During the past 10 years, APACPH has carried out such activities as setting up a data bank on the programs of its members, assessing publichealth problems, designing new curriculum and systems for service delivery, facilitating information and faculty exchanges, and running workshops for academic administrators. It has also organized conferences on the impact of urbanization on health, aging, child survival, AIDS, and occupational health. Since 1987 it has published the Asia-Pacific Journal of PublicHealth, the only English language journal on publichealth issues in the Asia and Pacific region, which will feature work being done by non-English-speaking researchers. Emphasis in the coming years will be placed on setting common standards for teaching and research, so that members can make more use of each other's programs. It is hoped that membership of the Consortium will continue to expand. A particular concern will be to focus more resources on preventive care rather than curative. PMID:7945762

The Institute of Medicine's report, Who Will Keep the Public Healthy? Educating PublicHealth Professionals for the 21st Century, recommended that publichealth education be accessible to undergraduate students. Promoting access to publichealth education will ideally contribute to a well-educated publichealth workforce, thus assuring the fulfillment of the publichealth mission. In response to this call to action, the authors examined the current practice, feasibility, and value in developing a functional partnership between academic institutions and local boards of health in preparing future publichealth professionals. Local boards of health in New England were surveyed to: (1) establish a baseline of existing working relationships between them and nearby academic institutions; (2) examine the barriers that inhibit the development of their collaborations with academic partners; and (3) assess how they jointly advance publichealth workforce development. Despite the main barriers of a lack of time, staff, and funding that are often cited for the absence of collaborations between institutions, one New England state, in particular, reported that their academic institution and local board of health partnerships were important and effective. The authors discuss how academic-practice collaborations hold the potential to combine basic publichealth principles with leadership and governance experience offered by local boards of health. Such partnerships are underutilized and have the potential to integrate core publichealth concepts while facilitating applied experiential learning opportunities in a professional publichealth setting, thus contributing to the development of the future publichealth workforce. PMID:23897268

As the importance of physician involvement and leadership in crisis preparedness is recognized, the literature suggests that few physicians are adequately trained to practice effectively in a large-scale crisis situation. A logical method for addressing the emergency preparedness training deficiency identified across several medical specialties is to include disaster and emergency preparedness training in residency curricula. In this article, the authors outline the development and implementation of an emergency preparedness curriculum for the Johns Hopkins General Preventive Medicine Residency (JHGPMR) from 2004 to 2006. The curriculum consists of two components. The first was developed for the academic year in the JHGPMR and includes didactic lectures, practical exercises to apply new knowledge, and an opportunity to integrate the knowledge and skills in a real-world exercise. The second, developed for the practicum year of the residency, includes Web-based lectures and online content and culminates in a tabletop preparedness exercise. Topics for both components include weapons of mass destruction, risk communication and personal preparedness, aspects of local emergency response planning, and mental health and psychological aspects of terrorism. On the basis of the emergency preparedness training gap that has been identified in the literature, and the success of the three-year experience in implementing a preparedness training curriculum in the JHGPMR, the authors recommend incorporation of competency-based emergency preparedness training for residencies of all specialties, and offer insights into how the described curriculum could be adapted for use in other residency settings. PMID:18316882

Aim: Evaluating hospital disaster preparedness is one the best ways for hospital accreditation. The aim of this study was to evaluate the quality of outcome measure that offer the level of measurement, reliability and validity that are known as the ‘ psychometric properties’ of the current hospital disaster preparedness tools. Methods: In total, 140 studies were retrieved. Studies which had been published from 2000 to 2014 and had used hospital disaster preparedness tools were appraised by using the PRISMA guideline. The content quality and the quality of the psychometric properties of the retrieved tools were assessed by using the World Health Organization Criteria for Hospital Preparedness as well as the COSMIN criteria. Findings: Only 33 studies met the inclusion criteria. In total, eleven hospital disaster preparedness tools had been used in these 33 studies. These tools mainly focused on evaluating structural and non-structural aspects of hospital preparedness and paid little attention, if any, to the key functional aspect. Conclusion: Given the paramount importance of evaluating hospital disaster preparedness and the weaknesses of current preparedness evaluation tools, valid and reliable tools should be developed by using experts’ knowledge and experience through the processes of tool development and psychometric evaluation. Keywords: Hospital preparedness, Measurement tool, Disaster, Systematic review PMID:26425401

Two distinct but converging activities have the potential to alter the way local publichealth departments conduct business. These activities are the emergence of e-government and the addition of preparedness as a basic function of the publichealth system. Preparedness implies timely collaboration with government entities, community partners and…

Global publichealth is increasingly being seen as a speciality field within the university education of publichealth. However, the exact meaning of global publichealth is still unclear, resulting in varied curricula and teaching units among universities. The contextual differences between high- and low- and middle-income countries, and the process of globalization need to be taken into account while developing any global publichealth course. Global publichealth and publichealth are not separable and global publichealth often appears as an extension of publichealth in the era of globalization and interdependence. Though global publichealth is readily understood as health of global population, it is mainly practiced as health problems and their solutions set within low- and middle-income countries. Additional specialist competencies relevant to the context of low- and middle-income countries are needed to work in this field. Although there can be a long list of competencies relevant to this broad topic, available literature suggests that knowledge and skills related with ethics and vulnerable groups/issues; globalization and its impact on health; disease burden; culture, society, and politics; and management are important. PMID:26191520

This essay argues that medical and health humanists interested in the rhetorical work of publics can extend their research by attending to embodiment and infrastructure. In addition to discussing how such strategies are illustrated in the essays appearing in this special issue, I relate them to the rhetorical study of personal health records (PHRs) as described in consumer-directed arguments. I conclude by posing two questions to health and medical humanists: "How do discursive constructions of publics and more specific instantiations of embodied experiences mutually shape each other?" and "What do the infrastructures of health and medical users look like and involve in their enactment?" PMID:24748109

Caregiving has only recently been acknowledged by the nation as an important topic for millions of Americans. A psychological or sociological approach to care-giving services has been most often applied, with little attention to the population-based publichealth outcomes of caregivers. We conceptualize caregiving as an emerging publichealth issue involving complex and fluctuating roles. We contend that caregiving must be considered in the context of life span needs that vary according to the ages, developmental levels, mental health needs, and physical health demands of both caregivers and care recipients. PMID:17194871

... Disasters Health Disparities Profiles in PublicHealth Study Study Overview Graduates of CEPH-accredited schools and programs of publichealth are equipped with the population health skills to address the world’s most pressing health issues. ...

Epidemiologists and environmental health researchers have a joint responsibility to acquire scientific knowledge that matters to publichealth and to apply the knowledge gained in publichealth practice. We examine the nature and source of these social responsibilities, discuss a debate in the epidemiological literature on roles and responsibilities, and cite approaches to environmental justice as reflective of them. At one level, responsibility refers to accountability, as in being responsible for actions taken. A deeper meaning of responsibility corresponds to commitment to the pursuit and achievement of a valued end. Epidemiologists are committed to the scientific study of health and disease in human populations and to the application of scientific knowledge to improve the public's health. Responsibility is also closely linked to reliability. Responsible professionals reliably perform the tasks they set for themselves as well as the tasks society expects them to undertake. The defining axiom for our approach is that the health of the public is a social good we commit ourselves to pursue, thus assuming an obligation to contribute to its achievement. Epidemiologists cannot claim to be committed to publichealth as a social good and not accept the responsibility of ensuring that the knowledge gained in their roles as scientists is used to achieve that good. The social responsibilities of environmental health researchers are conspicuous in the environmental justice movement, for example, in community-based participatory research. Responsibility is an ethical concept particularly well suited to frame many key aspects of the ethics of our profession. PMID:14602514

Health service delivery is a key pillar of the health system management .The World Health Organization recently emphasized the need to develop adolescent -friendly health services to improve the care provided to young people throughout the world. However, there is limited peer reviewed literature on this subject therefore necessitating assessment of whether the existing health facilities are prepared to implement the adolescent friendly health services. Adolescent friendly health services remains a relatively new and sensitive area mainly due to restrictive norms and policies guiding the services. After International Conference on Population and Development in 1994, countries started implementing adolescent friendly health services. The Government of Kenya together with partners in an attempt to address the health challenges came up with the Adolescent package of care (APOC) in 2013 whose guidelines were finalized in November 2014 and released for use by service providers . Despite this package of care, there is still ineffective staff capacity in relation to skills and knowledge gap of health professionals, training needs, health resources as well as health system factors that can affect implementation of AFHS. The study explored ways of mitigating or addressing the barriers to implementation of these services. The study used both quantitative and qualitative approaches to collect data. The study utilized survey research adapting descriptive cross sectional design and semi-structured questionnaire to interview 348 health care providers and 472 adolescents in Mam Lucy Kibaki Hospital from 3rd May 2014 to 16 June 2014 .The key informants were mainly nurses, clinical officers and Medical doctors who were working at the health service delivery area at the time of study and were interviewed using an interview guide. The managers at the hospital were interviewed using an in-depth interview guide while the adolescents were interviewed through interview guide and focused

Health service delivery is a key pillar of the health system management. The World Health Organization recently emphasized the need to develop adolescent -friendly health services to improve the care provided to young people throughout the world. However, there is limited peer reviewed literature on this subject therefore necessitating assessment of whether the existing health facilities are prepared to implement the adolescent friendly health services. Adolescent friendly health services remains a relatively new and sensitive area mainly due to restrictive norms and policies guiding the services. After International Conference on Population and Development in 1994, countries started implementing adolescent friendly health services. The Government of Kenya together with partners in an attempt to address the health challenges came up with the Adolescent package of care (APOC) in 2013 whose guidelines were finalized in November 2014 and released for use by service providers . Despite this package of care, there is still ineffective staff capacity in relation to skills and knowledge gap of health professionals, training needs, health resources as well as health system factors that can affect implementation of AFHS. The study explored ways of mitigating or addressing the barriers to implementation of these services. The study used both quantitative and qualitative approaches to collect data. The study utilized survey research adapting descriptive cross sectional design and semi-structured questionnaire to interview 348 health care providers and 472 adolescents in Mam Lucy Kibaki Hospital from 3rd May 2014 to 16 June 2014. The key informants were mainly nurses, clinical officers and Medical doctors who were working at the health service delivery area at the time of study and were interviewed using an interview guide. The managers at the hospital were interviewed using an in-depth interview guide while the adolescents were interviewed through interview guide and focused

This article addresses illegal drug use within the current debate in traditional publichealth and in proposals from Latin America, while emphasizing the need to approach the issue from an alternative publichealth perspective centered on individual users, groups, and social movements as protagonists. This counterhegemonic approach thus aims to orient the discussion on the need for inclusive and democratic public policies. Illegal drug use has been addressed from various perspectives: clinical medicine, viewing it as a problem that generates mental disorders and infectious diseases, both through risky sexual practices and/or use of injecting paraphernalia; from a legal perspective, as a problem related to delinquency; and according to traditional publichealth, as a problem that generates school dropout and work absenteeism and increases the demand on health services, in addition to increasing violence and death. However, not all forms of drug consumption involve problematic use, nor do they all trigger disorders related to substance use. PMID:27462857

Publichealth materials are often designed to inform and rally the public to spur action and maintain vigilance on important issues to family, work, community, and public policy. Limited access to publichealth information certainly curtails knowledge and awareness but may also hamper action and civic involvement. A growth in published assessments of health materials indicates an increased interest in the mismatch between the reading level of most health materials and the reading ability of the average adult. However, while several guidebooks offer suggestions for developing new materials, little attention has been given to the process of rewriting materials and grappling with bureaucratic language. We describe, in this case study, a process we used to assess and then rewrite a federally mandated report to consumers about the quality of their water. PMID:15360033

This review highlights emerging areas of interest in publichealth genomics. First, recent advances in newborn screening (NBS) are described, with a focus on practice and policy implications of current and future efforts to expand NBS programs (e.g., via next-generation sequencing). Next, research findings from the rapidly progressing field of epigenetics and epigenomics are detailed, highlighting ways in which our emerging understanding in these areas could guide future intervention and research efforts in publichealth. We close by considering various ethical, legal and social issues posed by recent developments in publichealth genomics; these include policies to regulate access to personal genomic information; the need to enhance genetic literacy in both health professionals and the public; and challenges in ensuring that the benefits (and burdens) from genomic discoveries and applications are equitably distributed. Needs for future genomics research that integrates across basic and social sciences are also noted. PMID:25184533

An inquiry into options for Masters-level training and into attitudes and perceptions among a convenience sample of nutrition students and professionals from 11 countries suggests that the term, "PublicHealth Nutrition", as such, is poorly represented and poorly understood in the Latin American region. At least six countries (Brazil, Chile, Cuba, Mexico, Peru, Puerto Rico) at seven sites have Masters programs to provide training for nutrition in a publichealth context or publichealth with an emphasis in nutrition. Exploring alliances from the Americas with the formal PHN discipline emerging in Europe should enrich the mutual perspective on curriculum design. However, the form and context of postgraduate training in Latin America must consider first and foremost its own job-markets, diverse publichealth needs, and resource allocations in building or transforming training programs. PMID:15806833

Federal, state, and local labor laws establish minimum standards for working conditions, including wages, work hours, occupational safety, and collective bargaining. The adoption and enforcement of labor laws protect and promote social, economic, and physical determinants of health, while incomplete compliance undermines these laws and contributes to health inequalities. Using existing legal authorities, some publichealth agencies may be able to contribute to the adoption, monitoring, and enforcement of labor laws. We describe how routine publichealth functions have been adapted in San Francisco, California, to support compliance with minimum wage and workers' compensation insurance standards. Based on these experiences, we consider the opportunities and obstacles for health agencies to defend and advance labor standards. Increasing coordinated action between health and labor agencies may be a promising approach to reducing health inequities and efficiently enforcing labor standards. PMID:24179278

Federal, state, and local labor laws establish minimum standards for working conditions, including wages, work hours, occupational safety, and collective bargaining. The adoption and enforcement of labor laws protect and promote social, economic, and physical determinants of health, while incomplete compliance undermines these laws and contributes to health inequalities. Using existing legal authorities, some publichealth agencies may be able to contribute to the adoption, monitoring, and enforcement of labor laws. We describe how routine publichealth functions have been adapted in San Francisco, California, to support compliance with minimum wage and workers' compensation insurance standards. Based on these experiences, we consider the opportunities and obstacles for health agencies to defend and advance labor standards. Increasing coordinated action between health and labor agencies may be a promising approach to reducing health inequities and efficiently enforcing labor standards. PMID:24179278

"Presenteeism" occurs when an employee goes to work despite a medical illness that will prevent him or her from fully functioning at work. This problem has been well studied in the business and social science literature, and carries increased importance in the health care setting due to the risk of infectious disease transmission in vulnerable patient populations. In this manuscript, we discuss an outbreak of viral gastroenteritis in a long-term care facility and the role presenteeism played in disease transmission and extension of the outbreak. We use existing literature to point out the hazards of presenteeism in the health care sector. We will also discuss factors that may be involved in the decision to work while ill and propose policy changes that may reduce the incidence of presenteeism in health care organizations. PMID:20549378

Significant strides have been made over the past 10 to 15 years to develop medical countermeasures (MCMs) to address potential disaster hazards, including chemical, biological, radiologic, and nuclear threats. Significant and effective collaboration between the pediatric health community, including the American Academy of Pediatrics, and federal partners, such as the Office of the Assistant Secretary for Preparedness and Response, Centers for Disease Control and Prevention, Federal Emergency Management Agency, National Institutes of Health, Food and Drug Administration, and other federal agencies, over the past 5 years has resulted in substantial gains in addressing the needs of children related to disaster preparedness in general and MCMs in particular. Yet, major gaps still remain related to MCMs for children, a population highly vulnerable to the effects of exposure to such threats, because many vaccines and pharmaceuticals approved for use by adults as MCMs do not yet have pediatric formulations, dosing information, or safety information. As a result, the nation's stockpiles and other caches (designated supply of MCMs) where pharmacotherapeutic and other MCMs are stored are less prepared to address the needs of children compared with those of adults in the event of a disaster. This policy statement provides recommendations to close the remaining gaps for the development and use of MCMs in children during publichealth emergencies or disasters. The progress made by federal agencies to date to address the needs of children and the shared commitment of collaboration that characterizes the current relationship between the pediatric health community and the federal agencies responsible for MCMs should encourage all child advocates to invest the necessary energy and resources now to complete the process of remedying the remaining significant gaps in preparedness. PMID:26729737

This article by Doctor Wood is especially interesting to health workers and indeed to all readers of the Journal on account of the fact that it treats in a concise manner some of the fundamental points of importance known at the present time regarding this devastating disease. It is particularly suggestive as it indicates various ways in which state and local health authorities can direct their activities so that the people may be informed of the fact that early cancer is curable in most instances. PMID:18009399

In 1997, under the auspices of the Turning Point program, New Hampshire's publichealth stakeholders convened a strategic planning process to transform the state publichealth system. What emerged was a fundamental vision that the publichealth system could only be improved by strengthening the capacity of local communities to address local health issues. A plan was developed to create regional publichealth structures, in areas with no local health departments, to deliver essential publichealth services at the local level. Seven years later, that plan has become the New Hampshire PublicHealth Network. The network now covers 67% of the New Hampshire population and includes 113 (48%) cities and towns. Pre- and postevaluations to assess local publichealth infrastructure at the inception of the program and following 2 years of funding and technical assistance showed significant improvement in local publichealth capacity and performance. This article describes the development of local publichealth structures in New Hampshire where none had previously existed. PMID:15711445

Using a social-ecological framework, we drew on a targeted literature review and historical and contemporary cases from the US labor movement to illustrate how unions address physical and psychosocial conditions of work and the underlying inequalities and social determinants of health. We reviewed labor involvement in tobacco cessation, hypertension control, and asthma, limiting articles to those in English published in peer-reviewed publichealth or medical journals from 1970 to 2013. More rigorous research is needed on potential pathways from union membership to health outcomes and the facilitators of and barriers to union-publichealth collaboration. Despite occasional challenges, publichealth professionals should increase their efforts to engage with unions as critical partners. PMID:25521905

Behavioral economics provides an empirically informed perspective on how individuals make decisions, including the important realization that even subtle features of the environment can have meaningful impacts on behavior. This commentary provides examples from the literature and recent government initiatives that incorporate concepts from behavioral economics in order to improve health, decision making, and government efficiency. The examples highlight the potential for behavioral economics to improve the effectiveness of publichealth policy at low cost. Although incorporating insights from behavioral economics into publichealth policy has the potential to improve population health, its integration into government publichealth programs and policies requires careful design and continual evaluation of such interventions. Limitations and drawbacks of the approach are discussed. PMID:27102853

The Institute of Medicine has stated that legal structures and the authority vested in health agencies and other partners within the publichealth system are essential to improving the public's health. Variation between the laws of different jurisdictions within the United States allows for natural experimentation and research into their…

Supporters of eugenics, the powerful early 20th-century movement for improving human heredity, often attacked that era's dramatic improvements in publichealth and medicine for preserving the lives of people they considered hereditarily unfit. Eugenics and publichealth also battled over whether heredity played a significant role in infectious diseases. However, American publichealth and eugenics had much in common as well. Eugenic methods often were modeled on the infection control techniques of publichealth. The goals, values, and concepts of disease of these two movements also often overlapped. This paper sketches some of the key similarities and differences between eugenics and publichealth in the United States, and it examines how their relationship was shaped by the interaction of science and culture. The results demonstrate that eugenics was not an isolated movement whose significance is confined to the histories of genetics and pseudoscience, but was instead an important and cautionary part of past publichealth and a general medical history as well. PMID:9366633

To counter negative publicity about the tobacco industry, Philip Morris has widely publicized its philanthropy initiatives. Although corporate philanthropy is primarily a public relations tool, contributions may be viewed as offsetting the harms caused by corporate products and practices. That such donations themselves have harmful consequences has been little considered. Drawing on internal company documents, we explored the philanthropy undertaken as part of Philip Morris's PM21 image makeover. Philip Morris explicitly linked philanthropy to government affairs and used contributions as a lobbying tool against publichealth policies. Through advertising, covertly solicited media coverage, and contributions to legislators' pet causes, Philip Morris improved its image among key voter constituencies, influenced public officials, and divided the publichealth field as grantees were converted to stakeholders. PMID:18923118

To counter negative publicity about the tobacco industry, Philip Morris has widely publicized its philanthropy initiatives. Although corporate philanthropy is primarily a public relations tool, contributions may be viewed as offsetting the harms caused by corporate products and practices. That such donations themselves have harmful consequences has been little considered. Drawing on internal company documents, we explored the philanthropy undertaken as part of Philip Morris's PM21 image makeover. Philip Morris explicitly linked philanthropy to government affairs and used contributions as a lobbying tool against publichealth policies. Through advertising, covertly solicited media coverage, and contributions to legislators’ pet causes, Philip Morris improved its image among key voter constituencies, influenced public officials, and divided the publichealth field as grantees were converted to stakeholders. PMID:18923118

This article is concerned with the application of market segmentation techniques in order to improve the planning and implementation of publichealth education programs. Seven distinctive patterns of health attitudes, social influences, and behaviors are identified using cluster analytic techniques in a sample drawn from four central California cities, and are subjected to construct and predictive validation: The lifestyle clusters predict behaviors including seatbelt use, vitamin C use, and attention to health information. The clusters also predict self-reported improvements in health behavior as measured in a two-year follow-up survey, e.g., eating less salt and losing weight, and self-reported new moderate and new vigorous exercise. Implications of these lifestyle clusters for publichealth education and intervention planning, and the larger potential of lifestyle clustering techniques in publichealth efforts, are discussed. PMID:2055779

Within the current exercise of reforming the health care system, underlying all issues, is the reassessment of the role of government. It is a government's responsibility and concern that the health sector be accessible and equitable to the population, and more important that the health sector be more efficient and affordable. Many governments in the world attempt to provide universal health care services to their population through publichealth care provisions. This paper reviews and analyses the experience of the Malaysian health system, focusing on the performance of the system in relation to access and equity. The performance of the Malaysian health system has been impressive. At minimum cost it has achieved virtually accessible and equitable health care to the entire population. This is evident by analysing almost all the commonly used indicators. These clearly show that when matched to comparable countries, health outcome is even better than predicted value. PMID:8870140

Background Improving health in our nation requires strengthening four major domains of the health care system: personal health management, health care delivery, publichealth, and health-related research. Many avoidable shortcomings in the health sector that result in poor quality are due to inaccessible data, information, and knowledge. A national health information infrastructure (NHII) offers the connectivity and knowledge management essential to correct these shortcomings. Better health and a better health system are within our reach. Discussion A national health information infrastructure for the United States should address the needs of personal health management, health care delivery, publichealth, and research. It should also address relevant global dimensions (e.g., standards for sharing data and knowledge across national boundaries). The public and private sectors will need to collaborate to build a robust national health information infrastructure, essentially a 'paperless' health care system, for the United States. The federal government should assume leadership for assuring a national health information infrastructure as recommended by the National Committee on Vital and Health Statistics and the President's Information Technology Advisory Committee. Progress is needed in the areas of funding, incentives, standards, and continued refinement of a privacy (i.e., confidentiality and security) framework to facilitate personal identification for health purposes. Particular attention should be paid to NHII leadership and change management challenges. Summary A national health information infrastructure is a necessary step for improved health in the U.S. It will require a concerted, collaborative effort by both public and private sectors. If you cannot measure it, you cannot improve it. Lord Kelvin PMID:12525262

Alterations in coastal ecology are expanding the geographic extent, frequency, magnitude, and species complexity'' of algal blooms throughout the world, increasing the threat of fish and shellfish poisonings, anoxia in marine nurseries, and of cholera. The World Health Organization and members of the medical profession have described the potential health effects of global climate change. They warn of the consequences of increased ultraviolet-B (UV-B) rays and of warming: the possible damage to agriculture and nutrition, and the impact on habitats which may alter the distribution of vector-borne and water-based infectious diseases. Algal growth due to increased nitrogen (N) and phosphorus (P) and warming are already affecting marine microflora and aquatic plants; and there is now clear evidence that marine organisms are a reservoir for enteric pathogens. The pattern of cholera in the Western Hemisphere suggests that environmental changes have already begun to influence the epidemiology of this infectious disease. 106 refs.

A survey of 20 publichealth schools and 240 university schools of nursing found that nuclear war related content was most likely to be appear in disaster nursing and in environmental health courses. Innovative curricula included political action projects for nuclear war prevention. (FMW)

Career guidance may have the potential to promote publichealth by contributing positively to both the prevention of mental health conditions and to population level well-being. The policy implications of this possibility have received little attention. Career guidance agencies are well placed to reach key target groups. Producing persuasive…

Sustainability remains a key challenge in publichealth. The perspective article by Fagen and Flay adds to our understanding of technical factors associated with sustaining health interventions in schools. In this commentary, the Fagen and Flay article (2009) is considered within the broader literature on sustainability. By taking a broad view,…

Individuals with Acquired Immune Deficiency Syndrome (AIDS) or AIDS-related conditions (ARC) need continual care and support, at a level which can severely tax the health resources of a community. Publichealth nursing should have a central role in the effective and efficient response to this devastating problem. Since the early stages of the AIDS…

In 1995, the National Library of Medicine (NLM) and the PublicHealth Service (PHS) recommended that special attention be given to the information needs of unaffiliated publichealth professionals. In response, the National Network of Libraries of Medicine (NN/LM) Greater Midwest Region initiated a collaborative outreach program for publichealth professionals working in rural east and central Iowa. Five publichealth agencies were provided equipment, training, and support for accessing the Internet. Key factors in the success of this project were: (1) the role of collaborating agencies in the implementation and ongoing success of information access outreach projects; (2) knowledge of the socio-cultural factors that influence the information-seeking habits of project participants (publichealth professionals); and (3) management of changing or varying technological infrastructures. Working with their funding, personnel from federal, state, and local governments enhanced the information-seeking skills of publichealth professionals in rural eastern and central Iowa communities. PMID:10783972

North Dakota, as a rural state with a decentralized publichealth system, has found the National PublicHealth Performance Standards Program useful in assessing performance of the state's publichealth system. The local instrument was used for local publichealth systems and on Native American reservations. A description of the process as well as aggregated results of the local performance assessment is presented. An importance ranking scale was combined with the performance scores to identify priority areas. Priority needs were specifically identified for developing community health profiles, working more closely with community partnerships, and increasing emphasis on health education activities. The process was a good opportunity for bringing partners together in local publichealth systems and for developing interest in using the more complete strategic planning tools in Mobilizing for Action through Planning and Partnerships. PMID:16103817

Graduate students and postdoctoral fellows—including those at the Harvard School of PublicHealth (HSPH)—have somewhat limited opportunities outside of traditional coursework to learn holistically about publichealth. Because this lack of familiarity could be a barrier to fruitful collaboration across disciplines, HSPH postdocs sought to address this challenge. In response, the PublicHealth 101 Nanocourse was developed to provide an overview of five core areas of publichealth (biostatistics, environmental health sciences, epidemiology, health policy and management, and social and behavioral sciences) in a two half-day course format. We present our experiences with developing and launching this novel approach to acquainting wider multidisciplinary audiences with the field of publichealth. PMID:25706019

HELIX-Atlanta was developed to support current and future state and local EPHT programs to implement data linking demonstratio'n projects which could be part of the EPHT Network. HELIX-Atlanta is a pilot linking project in Atlanta for CDC to learn about the challenges the states will encounter. NASA/MSFC and the CDC are partners in linking environmental and health data to enhance publichealth surveillance. The use of NASA technology creates value - added geospatial products from existing environmental data sources to facilitate publichealth linkages. Proving the feasibility of the approach is the main objective

The innovative practice that resulted from the Ottawa Charter challenges publichealth knowledge about programming and evaluation. Specifically, there is a need to formulate program theory that embraces social determinants of health and local actors’ mobilization for social change. Likewise, it is imperative to develop a theory of evaluation that fosters reflexive understanding of publichealth programs engaged in social change. We believe advances in contemporary social theory that are founded on a critique of modernity and that articulate a coherent theory of practice should be considered when addressing these critical challenges. PMID:15798114

Inter-organizational networks represent one of the most promising practice-based approaches in publichealth as a way to attain resources, share knowledge, and, in turn, improve population health outcomes. However, the interdependencies and effectiveness related to the structure, management, and costs of these networks represents a critical item to be addressed. The objective of this research is to identify and determine the extent to which potential partnering patterns influence the structure of collaborative networks. This study examines data collected by PARTNER, specifically publichealth networks (n = 162), to better understand the structured relationships and interactions among publichealth organizations and their partners, in relation to collaborative activities. Combined with descriptive analysis, we focus on the composition of publichealth collaboratives in a series of Exponential Random Graph (ERG) models to examine the partnerships between different organization types to identify the attribute-based effects promoting the formation of network ties within and across collaboratives. We found high variation within and between these collaboratives including composition, diversity, and interactions. The findings of this research suggest common and frequent types of partnerships, as well as opportunities to develop new collaborations. The result of this analysis offer additional evidence to inform and strengthen publichealth practice partnerships. PMID:26445053

Inter-organizational networks represent one of the most promising practice-based approaches in publichealth as a way to attain resources, share knowledge, and, in turn, improve population health outcomes. However, the interdependencies and effectiveness related to the structure, management, and costs of these networks represents a critical item to be addressed. The objective of this research is to identify and determine the extent to which potential partnering patterns influence the structure of collaborative networks. This study examines data collected by PARTNER, specifically publichealth networks (n = 162), to better understand the structured relationships and interactions among publichealth organizations and their partners, in relation to collaborative activities. Combined with descriptive analysis, we focus on the composition of publichealth collaboratives in a series of Exponential Random Graph (ERG) models to examine the partnerships between different organization types to identify the attribute-based effects promoting the formation of network ties within and across collaboratives. We found high variation within and between these collaboratives including composition, diversity, and interactions. The findings of this research suggest common and frequent types of partnerships, as well as opportunities to develop new collaborations. The result of this analysis offer additional evidence to inform and strengthen publichealth practice partnerships. PMID:26445053

Long-term objectives associated with cancer survivors have been suggested by Healthy People 2020, including increasing the proportion of survivors living beyond 5 years after diagnosis and improving survivors’ mental and physical health-related quality of life. Prior to reaching these objectives, several intermediate steps must be taken to improve the physical, social, emotional, and financial well-being of cancer survivors. Publichealth has a role in developing strategic, actionable, and measurable approaches to facilitate change at multiple levels to improve the lives of survivors and their families. The social ecological model has been used by the publichealth community as the foundation of multilevel intervention design and implementation, encouraging researchers and practitioners to explore methods that promote internal and external changes at the individual, interpersonal, organizational, community, and policy levels. The survivorship community, including publichealth professionals, providers, policymakers, survivors, advocates, and caregivers, must work collaboratively to identify, develop, and implement interventions that benefit cancer survivors. The National Action Plan for Cancer Survivorship highlights publichealth domains and associated strategies that can be the impetus for collaboration between and among the levels in the social ecological model and are integral to improving survivor outcomes. This paper describes the PublicHealth Action Model for Cancer Survivorship, an integrative framework that combines the National Action Plan for Cancer Survivorship with the social ecological model to demonstrate how interaction among the various levels may promote better outcomes for survivors. PMID:26590641

Avian influenza A H5N1 continues to be a major threat to global publichealth as it is a likely candidate for the next influenza pandemic. To protect publichealth and avert potential disruption to the economy, the Hong Kong Special Administrative Region Government has committed substantial effort in preparedness for avian and pandemic influenza. Publichealth infrastructures for emerging infectious diseases have been developed to enhance command, control and coordination of emergency response. Strategies against avian and pandemic influenza are formulated to reduce opportunities for human infection, detect pandemic influenza timely, and enhance emergency preparedness and response capacity. Key components of the pandemic response include strengthening disease surveillance systems, updating legislation on infectious disease prevention and control, enhancing traveller health measures, building surge capacity, maintaining adequate pharmaceutical stockpiles, and ensuring business continuity during crisis. Challenges from avian and pandemic influenza are not to be underestimated. Implementing quarantine and social distancing measures to contain or mitigate the spread of pandemic influenza is problematic in a highly urbanised city like Hong Kong as they involved complex operational and ethical issues. Sustaining effective risk communication campaigns during interpandemic times is another challenge. Being a member of the global village, Hong Kong is committed to contributing its share of efforts and collaborating with health authorities internationally in combating our common publichealth enemy. PMID:18618061

Veterinary oncology has seen tremendous growth since the first textbook devoted to the subject in the late 1970s. Cancer is usually at the top of the list when owners ask about health concerns for their pets (and it remains the leading cause of death among dogs and cats). The volume, Veterinary Oncology Secrets, joins others in the series by presenting in question and answer format the type of information so important to veterinary students, interns and residents, general practitioners, and specialists in a number of clinical fields.

This commentary discusses the historical development, organization and activities of the Ethiopian PublicHealth Association (EPHA), a professional civil society organization that operates on the principles of protection of public interest and professional standards in health in areas of health development in Ethiopia. The important roles played by the EPHA in health training, research and policy advocacy have been highlighted. Some of the important health system interventions that have been effected in the country through the influence and active participation of the Association have also been pointed out. As an active member of the Executive Board of the World Federation of PublicHealth Associations, EPHA serves as a role model for publichealth professional associations in the African Region with regard to increasing their influence in health policy and interventions within their respective countries. PMID:21370778

The new, national Public Mental Health Network offers health visitors and school nurses an opportunity to gain more of a voice within policy. The Network is hosted by the Royal College of Psychiatrists and works closely with PublicHealth England and NHS England to improve population mental health and to prevent mental illness.The CPHVA, RCN and other professional bodies have a vital role to fill in shaping development of the Network, including sharing good practice, interprofessional education and innovative publichealth research. In the past, the publichealth community has often been slow and uncoordinated in responding to either grassroots needs or government imperatives. In particular, voices advocating for better mental health for children and families have not been heard. Trade Unionists know that solidarity amplifies the voice of individuals. My own interest as a professor is to build on all we know that makes families, schools, neighbourhoods (and groups of practitioners) more resilient--and capable of more and more. PMID:26368996

Ethical guidelines for conducting clinical trials have historically been based on a perceived therapeutic obligation to treat and benefit the patient‐participants. The origins of this ethical framework can be traced to the Hippocratic oath originally written to guide doctors in caring for their patients, where the overriding moral obligation of doctors is strictly to do what is best for the individual patient, irrespective of other social considerations. In contrast, although medicine focuses on the health of the person, publichealth is concerned with the health of the entire population, and thus, publichealth ethics is founded on the societal responsibility to protect and promote the health of the population as a whole. From a publichealth perspective, research ethics should be guided by giving due consideration to the risks and benefits to society in addition to the individual research participants. On the basis of a duty to protect the population as a whole, a fiduciary obligation to realise the social value of the research and the moral responsibility to distribute the benefits and burdens of research fairly across society, how a publichealth perspective on research ethics results in fundamental re‐assessments of the proper course of action for two salient topical issues in research ethics is shown: stopping trials early for reasons of efficacy and the conduct of research on less expensive yet less effective interventions. PMID:17145915

Soils sustain life. They affect human health via quantity, quality, and safety of available food and water, and via direct exposure of individuals to soils. Throughout the history of civilization, soil-health relationships have inspired spiritual movements, philosophical systems, cultural exchanges, and interdisciplinary interactions, and provided medicinal substances of paramount impact. Given the climate, resource, and population pressures, understanding and managing the soil-health interactions becomes a modern imperative. We are witnessing a paradigm shift from recognizing and yet disregarding the 'soil-health' nexus complexity to parameterizing this complexity and identifying reliable controls. This becomes possible with the advent of modern research tools as a source of 'big data' on multivariate nonlinear soil systems and the multiplicity of health metrics. The phenomenon of suppression of human pathogens in soils and plants presents a recent example of these developments. Evidence is growing about the dependence of pathogen suppression on the soil microbial community structure which, in turn, is affected by the soil-plant system management. Soil eutrophication appears to create favorable conditions for pathogen survival. Another example of promising information-rich research considers links and feedbacks between the soil microbial community structure and structure of soil physical pore space. The two structures are intertwined and involved in the intricate self-organization that controls soil services to publichealth. This, in particular, affects functioning of soils as a powerful water filter and the capacity of this filter with respect to emerging contaminants in both 'green' and 'blue' waters. To evaluate effects of soil services to publichealth, upscaling procedures are needed for relating the fine-scale mechanistic knowledge to available coarse-scale information on soil properties and management. More needs to be learned about health effects of soils

The University at Albany School of PublicHealth has offered a Bachelor of Science in PublicHealth (BSPH) degree for the past 7 years. The final requirement of the BSPH degree is a capstone evidence-based publichealth class designed to culminate the degree program. This capstone course is framed by identifying a publichealth problem and creating a literature review based on this problem. The issues are selected through collaboration between the students and instructors. Developmental and analytical tools necessary to complete the literature review are provided throughout the semester. By the end of the course, students achieve the necessary competencies and skills to identify a publichealth problem, analyze information from peer-reviewed literature, and synthesize the relationship between a health issue and its correlated outcome. Successes were measured through achievement of core BSPH competencies, quality of final paper and presentation, and qualitative data gleaned from end of semester self-reported student surveys. PMID:27148516

The University at Albany School of PublicHealth has offered a Bachelor of Science in PublicHealth (BSPH) degree for the past 7 years. The final requirement of the BSPH degree is a capstone evidence-based publichealth class designed to culminate the degree program. This capstone course is framed by identifying a publichealth problem and creating a literature review based on this problem. The issues are selected through collaboration between the students and instructors. Developmental and analytical tools necessary to complete the literature review are provided throughout the semester. By the end of the course, students achieve the necessary competencies and skills to identify a publichealth problem, analyze information from peer-reviewed literature, and synthesize the relationship between a health issue and its correlated outcome. Successes were measured through achievement of core BSPH competencies, quality of final paper and presentation, and qualitative data gleaned from end of semester self-reported student surveys. PMID:27148516

Future health prospects depend increasingly on globalisation processes and on the impact of global environmental change. Economic globalisation--entailng deregulated trade and investment--is a mixed blessing for health. Economic growth and the dissemination of technologies have widely enhanced life expectancy. However, aspects of globalisation are jeopardising health by eroding social and environmental conditions, exacerbating the rich-poor gap, and disseminating consumerism. Global environmental changes reflect the growth of populations and the intensity of economic activity. These changes include altered composition of the atmosphere, land degradation, depletion of terrestrial aquifers and ocean fisheries, and loss of biodiversity. This weakening of life-supporting systems poses health risks. Contemporary publichealth must therefore encompass the interrelated tasks of reducing social and health inequalities and achieving health-sustaining environments. PMID:10981904

Foodborne illness is prevented by inspection and surveillance conducted by health departments across America. Appropriate restaurant behavior is enforced and monitored via publichealth inspections. However, surveillance coverage provided by state and local health departments is insufficient in preventing the rising number of foodborne illness outbreaks. To address this need for improved surveillance coverage we conducted a supplementary form of publichealth surveillance using social media data: Yelp.com restaurant reviews in the city of San Francisco. Yelp is a social media site where users post reviews and rate restaurants they have personally visited. Presence of keywords related to health code regulations and foodborne illness symptoms, number of restaurant reviews, number of Yelp stars, and restaurant price range were included in a model predicting a restaurant's likelihood of health code violation measured by the assigned San Francisco publichealth code rating. For a list of major health code violations see (S1 Table). We built the predictive model using 71,360 Yelp reviews of restaurants in the San Francisco Bay Area. The predictive model was able to predict health code violations in 78% of the restaurants receiving serious citations in our pilot study of 440 restaurants. Training and validation data sets each pulled data from 220 restaurants in San Francisco. Keyword analysis of free text within Yelp not only improved detection of high-risk restaurants, but it also served to identify specific risk factors related to health code violation. To further validate our model we applied the model generated in our pilot study to Yelp data from 1,542 restaurants in San Francisco. The model achieved 91% sensitivity 74% specificity, area under the receiver operator curve of 98%, and positive predictive value of 29% (given a substandard health code rating prevalence of 10%). When our model was applied to restaurant reviews in New York City we achieved 74% sensitivity

Foodborne illness is prevented by inspection and surveillance conducted by health departments across America. Appropriate restaurant behavior is enforced and monitored via publichealth inspections. However, surveillance coverage provided by state and local health departments is insufficient in preventing the rising number of foodborne illness outbreaks. To address this need for improved surveillance coverage we conducted a supplementary form of publichealth surveillance using social media data: Yelp.com restaurant reviews in the city of San Francisco. Yelp is a social media site where users post reviews and rate restaurants they have personally visited. Presence of keywords related to health code regulations and foodborne illness symptoms, number of restaurant reviews, number of Yelp stars, and restaurant price range were included in a model predicting a restaurant’s likelihood of health code violation measured by the assigned San Francisco publichealth code rating. For a list of major health code violations see (S1 Table). We built the predictive model using 71,360 Yelp reviews of restaurants in the San Francisco Bay Area. The predictive model was able to predict health code violations in 78% of the restaurants receiving serious citations in our pilot study of 440 restaurants. Training and validation data sets each pulled data from 220 restaurants in San Francisco. Keyword analysis of free text within Yelp not only improved detection of high-risk restaurants, but it also served to identify specific risk factors related to health code violation. To further validate our model we applied the model generated in our pilot study to Yelp data from 1,542 restaurants in San Francisco. The model achieved 91% sensitivity 74% specificity, area under the receiver operator curve of 98%, and positive predictive value of 29% (given a substandard health code rating prevalence of 10%). When our model was applied to restaurant reviews in New York City we achieved 74

This review of the publichealth role of social marketing begins by tracing the history of social marketing and noting that social marketing adopts the traditional marketing framework of product, price, place, and promotion and embraces several methods of commercial marketing as well as consumer research. However, no universally acknowledged definition exists. A review of the literature is divided into three time periods representing early theoretical development, the evaluation of experiences, and increasing acceptance. Concerns about social marketing are discussed in terms of ethics, disempowerment, and the commercialization of health information. Examples of social marketing are then provided from developing countries and are analyzed in groupings defined as tangible products, sustained health practices, and service utilization. Practitioners' views and concerns are also reviewed. The strengths of social marketing include knowledge of the audience, systematic use of qualitative methods, use of incentives, closer monitoring, strategic use of the mass media, realistic expectations, aspiring to high standards, and recognition of price. Weaknesses of social marketing include its time, money, and human requirements; the fact that marketing elements are missing (publichealth lacks the flexibility to adjust products and services to clients' interests and preferences); and the potential serious impact on the future of Public Service Announcements, which may die out because social marketers pay for air time. After placing social marketing in context with other practices designed to achieve social change, the review ends with the prediction that the publichealth role of social marketing is likely to increase. The World Health Organization's recent call for health promotion and the UN Children's Fund's social mobilization actions are provided as examples of this increased role. It is noted, however, that social marketing alone cannot solve publichealth problems. PMID

Elevated concentrations of arsenic in groundwater pose a publichealth threat to millions of people worldwide, including severely affected populations in South and Southeast Asia. While arsenic is an established human carcinogen and has been associated with a multitude of health outcomes in epidemiologic studies, a mode of action has yet to be determined for some aspects of arsenic toxicity. Herein, we emphasize the role of recent genetic and molecular epidemiologic investigations of arsenic toxicity. Additionally, we discuss considerations for the publichealth impacts of arsenic exposure through drinking water with respect to primary and secondary prevention efforts. PMID:22962196

Among the millions of children in the United States exposed to publichealth emergencies in recent years, those with preexisting health conditions face particular challenges. A publichealth emergency may, for example, disrupt treatment regimens or cause children to be separated from caregivers. Ongoing shortages of pediatricians and pediatric subspecialists may further exacerbate the risks that children with preexisting conditions face in disaster circumstances. The US Department of Homeland Security recently called for better integration of children's needs into all preparedness activities. To aid in this process, multiple legal concerns relevant to pediatricians and pediatric policymakers must be identified and addressed. Obtaining informed consent from children and parents may be particularly challenging during certain publichealth emergencies. States may need to invoke legal protections for children who are separated from caregivers during emergencies. Maintaining access to prescription medications may also require pediatricians to use specific legal mechanisms. In addition to practitioners, recommendations are given for policymakers to promote effective pediatric response to publichealth emergencies. PMID:23641730

During the 1980s, national policy promoted military expenditures and downsized domestic programs. These priorities, along with tax reform and deregulation, created a "domestic gulf crisis" with a new wave of vulnerable populations--poor children, the homeless, the elderly, and the uninsured. Our lack of a national health program compounds the problem. The 1990s will be a decade of change and challenge. To forge a healthier and stronger future for our nation, we must implement five publichealth imperatives: (1) We must have a national health program that is universal, comprehensive, and prevention-oriented, with built-in assurances for quality, efficiency, and a strong publichealth infrastructure. (2) We must have a comprehensive national health education and promotion program for all schoolchildren. (3) Women must have freedom of choice. (4) Prevention and publichealth must become one of our country's highest health priorities. (5) The federal government must increase its leadership, commitments, and resources to reach the goals set forth in Healthy Communities 2000 and Healthy People 2000. PMID:8484444

We assessed publichealth use of R0, the basic reproduction number, which estimates the speed at which a disease is capable of spreading in a population. These estimates are of great publichealth interest, as evidenced during the 2009 influenza A (H1N1) vírus pandemic. We reviewed methods commonly used to estimate R0, examined their practical utility, and assessed how estimates of this epidemiological parameter can inform mitigation strategy decisions. In isolation, R0 is a suboptimal gauge of infectious disease dynamics across populations; other disease parameters may provide more useful information. Nonetheless, estimation of R0 for a particular population is useful for understanding transmission in the study population. Considered in the context of other epidemiologically important parameters, the value of R0 may lie in better understanding an outbreak and in preparing a publichealth response. PMID:26581059

The American Journal of PublicHealth has reflected the relationship of publichealth to the field of mental health over its 75-year history. The earliest volumes of the Journal addressed movements and concerns within public mental health. Quantitative analysis of mental health articles shows wide fluctuations over the last 75 years, probably due to variations in federal funding for mental health research. Topical emphases in the Journal have included social issues and improved mental health, the contributions of epidemiological studies, and technological advances in prevention and treatment. PMID:3890568

This article examines the development of the St George's Hospital Medical School Library publichealth information service. Begun in 1997 as a pilot project to support PublicHealth Specialist Registrars in South Thames West, it is now an established part of postgraduate training in the region. An outline of the service is described, including the evolution of the post of PublicHealth Librarian. Issues influencing the development of the service, and the establishment of the Librarian as part of the publichealth network are discussed. This is a transferable model of publichealth information provision, which as a centralized resource makes best use of available funding. As a LIS model it is an effective and efficient way of maximizing resources, and delivering a service to a specialist user group that is spread across a wide geographical area. PMID:11260291

Studies of the effects of environmental exposures on domestic and wild animals can corroborate or inform epidemiologic studies in humans. Animals may be sensitive indicators of environmental hazards and provide an early warning system for publichealth intervention, as exemplified by the iconic canary in the coal mine. This article illustrates the application of animal sentinel research to elucidate the effects of exposure to traditional and emerging contaminants on human health. Focusing on environmental issues at the forefront of current publichealth research, the article describes exposures to community air pollution, environmental tobacco smoke, and pesticides and associations with cancer, reproductive outcomes, and infectious diseases. Finally, it covers the role of marine mammals in monitoring the health of the oceans and humans. PMID:21563712

Tuberculosis (TB) control in many ways exemplifies evidence-based publichealth practice, rigorously implemented, with appropriate emphasis on the central importance of political support for success. With more than 30 million patients treated in the past decade, TB control has important implications for managing both communicable and non-communicable diseases. Simple diagnostic tests, meticulously proven standardized treatment regimens with assured drug supply, supportive case management and a superb information system that tracks the progress of every patient, all facilitate effective program implementation. TB control shows that publichealth programs, including those that require long-term treatment in the primary care system, can be effective in poor countries; however, TB rates are heavily influenced by the social, environmental and epidemiologic context, emphasizing that treatment is not enough and that socio-economic factors may be more important determinants of epidemiologic trends than treatment programs. TB control is effective when it combines two essential components: a practical, implementable, proven technical package, and political commitment. Political commitment is also essential to implement other interventions that can improve health, including healthier air, water and food, as well as programs to prevent or reduce tobacco smoking, cardiovascular disease, cancer, obesity and other growing publichealth problems. By implementing evidence-based practices, ensuring operational excellence, using information systems that facilitate accountability and evaluation, and obtaining and maintaining political support, we can address the publichealth challenges of the twenty-first century. PMID:19335945

This qualitative study identifies the ideas regarding health education of 12 nurses who are part of the publichealth service of a city in the São Paulo countryside, and proposes a corresponding educational action. In this study, we used the methodology of action research. Data collection occurred in the second half of 2009 in the publichealth units of the mentioned municipality. Participant observation and interviews were implemented. The analysis and interpretation of data were conducted through categorization, based on the theory by Paulo Freire. As a result, the reductionism of health education in the pedagogical approach involving the transmission of knowledge was exposed, envisioning a biologicist tendency of academic training. However, in discussion circles, the awakening of political awareness related to the theme and the promotion of health was assumed. In conclusion, there is a need for changes in such training and for the facilitation of new modes of scientific production in the quest for social transformation. PMID:24601151

The article seeks out the regulations about publichealth in the oldest medieval statutes of fourteen cities of the eastern Croatian Adriatic coast, between the thirteenth and sixteenth century. The research revealed numerous examples of direct or indirect ways of protecting publichealth. Through the analyzed documents, a noteworthy relationship between public morality and publichealth can be noted. The described rules are important as a reflection of awareness about publichealth as a condition of survival and progress in the past. They witness a progressive transition from an original common law into a written law as well as the impact that religion had in influencing people's general opinion and lifestyle in light of publichealth problems. PMID:21674275

By comparing models of market-based allocation with state-controlled national health care systems, it will be suggested that the way in which different communities deal with the allocation of health care is central to their expression of what might be called a moral self-understanding. That is to say that the provision of health care may be expected to be a focus of communal debate, not simply about morally acceptable and unacceptable actions, but also about the community's understanding of what it is that makes for a worthwhile and morally defensible human life. This moral self-understanding is seen to be entwined with the different concepts of 'health' that are implicit in different systems of allocation. In conclusion, it will be suggested that decisions concerning health care allocation must be made in response to a continuing, public and open debate about what health and health care mean to a particular community. PMID:10185170

Children have been identified as particularly vulnerable to psychological and behavioral difficulties following disaster. Public child and family disaster communication is one publichealth tool that can be utilized to promote coping/resilience and ameliorate maladaptive child reactions following an event. We conducted a review of the public disaster communication literature and identified three main functions of child and family disaster communication: fostering preparedness, providing psychoeducation, and conducting outreach. Our review also indicates that schools are a promising system for child and family disaster communication. We complete our review with three conclusions. First, theoretically, there appears to be a great opportunity for public disaster communication focused on child disaster reactions. Second, empirical research assessing the effects of public child and family disaster communication is essentially nonexistent. Third, despite the lack of empirical evidence in this area, there is opportunity for public child and family disaster communication efforts that address new domains. PMID:27086315

In this paper, the authors consider the idea of the public biobank governance framework with respect to the innovative paradigm of One Health. The One Health initiative has been defined as an integrative and interdisciplinary effort to improve the lives and well-being of human beings and non-human animals, as well as to preserve the environment. Here, we use this approach as a starting presumption with respect to institutional design. We examine the theoretical and legal framework underlying the concept of biobanking that, being public orientated, is for the public good. We suggest that this account of research practice does not ethically correlate with One Health principles. Instead, we argue that One Health requires a model of biobanking that is based on universal goods, that is, goods that serve human beings as well as non-human animals and the environment, and which we define in detail. Our purpose is to begin a discussion on how One Health principles might be implemented in health initiatives. PMID:24570395

Over the last decade, publichealth and bioethics have been courting each other, trying to figure out a way to inform and assist one another. Ethics in publichealth began in epidemiology and publichealth in ethics began in health law. Attempts have been made to create both an ethics of and in publichealth. Although many edited volumes and even model curriculums have been created for the teaching of publichealth ethics, most efforts are mired in medical ethics and do not take the unique population perspective of publichealth. Several challenges to the development and teaching of publichealth ethics remain, including the issue of ethics being a required publichealth competency and the questions: what should be in a publichealth ethics curriculum, where will instructors be trained and how will such faculty be paid? A true publichealth ethics will help professionals address issues of values, critical thinking and decision making. PMID:19205316

Recent natural disasters such as the 2004 tsunami, 2008 Sichuan earthquake, and the 2008 Myanmar cyclone have killed more than 100,000 people each. Mortality and morbidity associated with natural disasters are a growing concern, especially because extreme climate events are likely to get increasingly frequent. The authors comment on Cyclone Nargis, claiming an extraordinarily high death toll during its devastating track through the Irrawaddy delta in Myanmar on May 2, 2008 and analyze how and why its mortality pattern differs from other typical postdisaster situations. Underlying factors and preconditions are described and the specificity of the Myanmese context is presented. This leads to lessons how excess mortality can be reduced in future high-ranked cyclones, whose recurrence in this region will only be a matter of time. PMID:20014544

There is little published literature on operational coordination during a real time disaster regardless of the setting. This study describes a university's emergency management plan and its execution in response to a specific natural disaster, the May 8, 2009 "inland hurricane," which was later classified as a "Super Derecho."…

Good practices in emergency preparedness and response for chemical incidents include practices specific to the different functions of exposure assessment (e.g., within the monitoring function, the use of mobile monitoring equipment; within the modelling function, the use of rapid dispersion models with integrated mapping software) and generic practices to engage incident response stakeholders to maximise exposure assessment capabilities (e.g., sharing protocols and pre-prepared information and multi-agency training and exercising). Such practices can optimise cross-border collaboration. A wide range of practices have been implemented across MSs during chemical incident response, particularly during incidents that have cross-border and trans-boundary impacts. This paper proposes a self-assessment methodology to enable MSs, or organisations within MSs, to examine exposure assessment capabilities and communication pathways between exposure assessors and publichealth risk assessors. Where gaps exist, this methodology provides links to good practices that could improve response, communication and collaboration across local, regional and national borders. A fragmented approach to emergency preparedness for chemical incidents is a major obstacle to improving cross-border exposure assessment. There is no one existing body or structure responsible for all aspects of chemical incident preparedness and response in the European Union. Due to the range of different organisations and networks involved in chemical incident response, emergency preparedness needs to be drawn together. A number of recommendations are proposed, including the use of networks of experts which link publichealth risk assessors with experts in exposure assessment, in order to coordinate and improve chemical incident emergency preparedness. The EU's recent Decision on serious cross-border threats to health aims to facilitate MSs' compliance with the International Health Regulations, which require

This report is a part of the program of the National Center for Health Statistics to provide current statistics as baseline data for the evaluation, planning, and administration of health programs. Part I presents data concerning the occupational fields: (1) administration, (2) anthropology and sociology, (3) data processing, (4) basic sciences,…

Publichealth nutrition is focused on the prevention of diet-related diseases and the attainment of good health, through policy, education and health promotion. It involves many sectors of the community, cooperating to improve the health and wellbeing of the population with emphasis on prevention, equity, wellbeing and improved quality of life. In the majority of western countries, an epidemic of coronary heart disease (CHD) began after World War One, reaching its peak in the 1970's. In Asia, the epidemic began after WW2 with the rapid economic development of the region. In western countries, of which Australia is a typical example, health promotion activities and improved hospital treatment have been effective in reducing the impact of the CHD epidemic. The life expectancy of the population has steadily grown to 75.6 years for males and 81.3 years for females. Despite major advances in the prevention and treatment of cardiovascular disease, it is still the leading cause of premature mortality and morbidity in Australia. Furthermore, cardiovascular disease shares common risk factors with other leading causes of death, including lifestyle behaviours (diet, physical inactivity, alcohol consumption, smoking), physiological states (obesity, hypertension, high blood cholesterol) and socioeconomic factors. For Asia, the challenge is to implement publichealth policies that will tackle the epidemic of chronic disease before it reaches its peak. Health Promotion policies will be important for all countries. The use of the disability adjusted life years (DALY) methodology to measure the association between the cause of disease and relate its occurrence to health outcomes will be an important publichealth planning tool. PMID:11338731

The paper considers the long-term trajectory of publichealth and whether a 'Golden Era' in PublicHealth might be coming to an end. While successful elements of the 20th century policy approach need still to be applied in the developing world, two significant flaws are now apparent within its core thinking. It assumes that continuing economic growth will generate sufficient wealth to pay for the publichealth infrastructure and improvement needed in the 21st century when, in reality, externalised costs are spiralling. Secondly, there is evidence of growing mismatch between ecosystems and human progress. While 20th century development has undeniably improved publichealth, it has also undermined the capacity to maintain life on a sustainable basis and has generated other more negative health consequences. For these and other reasons a rethink about the role, purpose and direction of publichealth is needed. While health has to be at the heart of any viable notion of progress the dominant policy path offers new versions of the 'health follows wealth' position. The paper posits ecological publichealth as a radical project to reshape the conditions of existence. Both of these broad paths require different functions and purposes from their institutions, professions and politicians. The paper suggests that eco-systems pressures, including climate change, are already adding to pressure for a change of course. PMID:26427314

Due to increasing national diversity, programs addressing cultural competence have multiplied in U.S. medical training institutions. Although these programs share common goals for improving clinical care for patients and reducing health disparities, there is little standardization across programs. Furthermore, little progress has been made to translate cultural competency training from the clinical setting into the publichealth setting where the focus is on population-based health, preventative programming, and epidemiological and behavioral research. The need for culturally relevant publichealth programming and culturally sensitive publichealth research is more critical than ever. Awareness of differing cultures needs to be included in all processes of planning, implementation and evaluation. By focusing on community-based health program planning and research, cultural competence implies that it is possible for publichealth professionals to completely know another culture, whereas intercultural competence implies it is a dual-sided process. Publichealth professionals need a commitment toward intercultural competence and skills that demonstrate flexibility, openness, and self-reflection so that cultural learning is possible. In this article, the authors recommend a number of elements to develop, adapt, and strengthen intercultural competence education in publichealth educational institutions. PMID:26389109

Due to increasing national diversity, programs addressing cultural competence have multiplied in U.S. medical training institutions. Although these programs share common goals for improving clinical care for patients and reducing health disparities, there is little standardization across programs. Furthermore, little progress has been made to translate cultural competency training from the clinical setting into the publichealth setting where the focus is on population-based health, preventative programming, and epidemiological and behavioral research. The need for culturally relevant publichealth programming and culturally sensitive publichealth research is more critical than ever. Awareness of differing cultures needs to be included in all processes of planning, implementation and evaluation. By focusing on community-based health program planning and research, cultural competence implies that it is possible for publichealth professionals to completely know another culture, whereas intercultural competence implies it is a dual-sided process. Publichealth professionals need a commitment toward intercultural competence and skills that demonstrate flexibility, openness, and self-reflection so that cultural learning is possible. In this article, the authors recommend a number of elements to develop, adapt, and strengthen intercultural competence education in publichealth educational institutions. PMID:26389109

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... 41 Public Contracts and Property Management 2 2011-07-01 2007-07-01 true PublicHealth Service... AND COMPLEXES 5.3-Federal Employee Health Services § 101-5.307 PublicHealth Service. (a) The only authorized contact point for assistance of and consultation with the PublicHealth Service is the...

... 41 Public Contracts and Property Management 2 2014-07-01 2012-07-01 true PublicHealth Service... AND COMPLEXES 5.3-Federal Employee Health Services § 101-5.307 PublicHealth Service. (a) The only authorized contact point for assistance of and consultation with the PublicHealth Service is the...

... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true PublicHealth Service... AND COMPLEXES 5.3-Federal Employee Health Services § 101-5.307 PublicHealth Service. (a) The only authorized contact point for assistance of and consultation with the PublicHealth Service is the...

... 41 Public Contracts and Property Management 2 2013-07-01 2012-07-01 true PublicHealth Service... AND COMPLEXES 5.3-Federal Employee Health Services § 101-5.307 PublicHealth Service. (a) The only authorized contact point for assistance of and consultation with the PublicHealth Service is the...

The applicability of remote sensing in the form of aerial photography to urban publichealth problems is examined. Environmental characteristics are analyzed to determine if health differences among areas could be predicted from the visual expression of remote sensing data. The analysis is carried out on a socioeconomic cross-sectional sample of census block groups. Six morbidity and mortality rates are the independent variables while environmental measures from aerial photographs and from the census constitute the two independent variable sets. It is found that environmental data collected by remote sensing are as good as census data in evaluating rates of health outcomes.

In District of Columbia v. Heller, the U.S. Supreme Court ruled that the Second Amendment protects an individual's right to own handguns in the home for protection, invalidating a Washington, D.C. law banning most handgun possession. The Heller decision, however, provided lower courts with little guidance regarding how to judge the constitutionality of gun laws other than handgun bans. Nevertheless, lower courts have upheld the vast majority of federal, state, and local gun laws challenged since Heller. One area in which some lower courts have disagreed has been the constitutionality of laws regulating the ability to carry firearms in public. This issue may be the next to be addressed by the Supreme Court under its evolving Second Amendment jurisprudence. Courts should carefully consider the negative publichealth and safety implications of gun carrying in public as they weigh the constitutionality of these laws. PMID:23590749

This report identifies a broad spectrum of issues affecting women's health and is divided into four sections: (1) social factors affecting women's health; (2) women's physical health and well-being; (3) health concerns of older women; and (4) issues related to alcohol, drug use and abuse, and the mental health of women. The PublicHealth Service…

This manual provides information needed to meet the standards for pesticide applicator certification. It presents pest control guidelines for those organisms of publichealth significance. Fact sheets with line drawings discuss pests such as cockroaches, bedbugs, lice, ants, beetles, bats, birds, and rodents. (CS)

This is an opinion piece that proposes a reflection on the current status of the interface between cyberculture and publichealth and its use as a means for research, not as a mere tool. Cyberculture thus represents a new form of interface between people. And it is precisely "through" and "by means of" social relations that individuals acquire skills and communication techniques. The forms and the means of the relationship alters, but the ends remain unchanged, namely to be in contact with other humans. In recent decades, with the advent of computers, the Internet and all the technological apparatus, human relationships are dependent on them, which is the modern so-called cyberculture. This now affects all areas of activity, and publichealth cannot be left behind, taking advantage of it and its benefits for its development. It is necessary to keep abreast of these changes and raise them from the theoretical to the practical plane, not only implementing publichealth policies but also taking the socio-virtual aspects into consideration. It is also necessary for the professionals involved to be updated on new forms of communication, interaction, research methodology, preparation of instruments, sampling approaches and all other phenomena arising from cyberculture that will work in partnership with publichealth. PMID:24863825

Phytotechnologies have potential to reduce the amount or toxicity of deleterious chemicals and agents, and thereby, can reduce human exposures to hazardous substances. As such, phytotechnologies are tools for primary prevention in publichealth. Recent research demonstrates phytotechnologies can be uniquely tailored for effective exposure prevention in a variety of applications. In addition to exposure prevention, plants can be used as sensors to identify environmental contamination and potential exposures. In this paper, we have presented applications and research developments in a framework to illustrate how phytotechnologies can meet basic publichealth needs for access to clean water, air, and food. Because communities can often integrate plant-based technologies at minimal cost and with low infrastructure needs, the use of these technologies can be applied broadly to minimize potential contaminant exposure and improve environmental quality. These natural treatment systems also provide valuable ecosystem services to communities and society. In the future, integrating and coordinating phytotechnology activities with publichealth research will allow technology development focused on prevention of environmental exposures to toxic compounds. Hence, phytotechnologies may provide sustainable solutions to environmental exposure challenges, improving publichealth and potentially reducing the burden of disease. PMID:23819283

Phytotechnologies have the potential to reduce the amount and/or toxicity of deleterious chemicals/agents, and thereby, prevent human exposures to hazardous substances. As such, phytotechnologies are a tool for primary prevention within the context of publichealth. Research advances demonstrate that phytotechnologies can be uniquely tailored for effective exposure prevention for a variety of applications. In addition to exposure prevention, phytotechnologists have advanced the use of plants as sensors to delineate environmental contaminants and potential exposures. The applications presented in this paper are at various stages of development and are presented in a framework to reflect how phytotechnologies can help meet basic publichealth needs for access to clean water, air, and food resources. As plant-based technologies can often be integrated into communities at minimal cost and with low infrastructure needs, their use in improving environmental quality can be applied broadly to minimize potential contaminant exposure. These natural treatment systems concurrently provide ecosystem services of notable value to communities and society. In the future, integration and coordination of phytotechnology activities with publichealth research will allow technology development that focuses on prevention of environmental exposures. Such an approach will lead to an important role of phytotechnologies in providing sustainable solutions to environmental exposure challenges that improve publichealth and potentially reduce the burden of disease. PMID:23819283

This article presents comments and observations given by Dr. Shiriki K. Kumanyika as the Lautenberg Award Lecture at the commencement of the University of Medicine and Dentistry of New Jersey-Rutgers School of PublicHealth, May 20, 2013. The award is named after Senator Frank Lautenberg, who served as a U.S. Senator from New Jersey during 1982 to…

Patient activation is a new term for a perennial problem. People know what they need to do for their health: exercise, eat right, and get enough rest--but how are they motivated to actually do these things? This is what patient activation is. From this author's vantage point as a medical librarian, public libraries are well-placed to be part of…

There is a bewildering array of nutrition information available to the public and to professionals. Nutrition messages are often conflicting, confusing, and often simply rhetoric. More consumer research is needed to understand more fully the best way to communicate health messages, recommendations, ...

This manual gives general control principles and specific information on control of mosquitoes, flies, bedbugs, fleas, lice, cockroaches, venomous arthropods, ticks and chiggers, and rodents. The specific information includes life-cycles and habitats, publichealth importance, non-chemical control, and control with pesticides. (BB)

This training manual provides information needed to meet the minimum EPA standards for certification as a commercial applicator of pesticides in the publichealth pest control category. The text discusses pests such as roaches, bedbugs, bees, mosquitoes, gnats, flies, and rodents with possible control measures provided. (CS)

In its decision on the Affordable Care Act, the Supreme Court opened the door for Congress to use its taxing power to achieve myriad policy objectives. The federal government may now increasingly make creative use of taxes to pursue publichealth goals. PMID:23075142

In the space of just a few years, the amount and nature of scientific research on women's health has emerged as a major policy issue being addressed at the highest levels of the federal government and in the mainstream media. This debate has engaged members of Congress, the National Institutes of Health, and other federal agencies, and medical, scientific, health, and women's organizations. Sociologists have made significant contributions to both the process by which the women's health research issue has ascended to public awareness and the content of its agenda. Many of these contributions go unrecognized and other potential contributions by medical sociologists remain unrealized. In order to advance both science and practice in women's health--by ensuring the inclusion of the sociological perspective--we encourage sociologists to participate more directly in the policy debates. PMID:7560844